Jeff Musson

The applicant sought to invalidate a Settlement Disclosure Notice (SDN) he signed in 2011, which settled his accident benefits claim for $115,000.

He argued the SDN was defective for failing to distinguish between different periods of Income Replacement Benefits and for lacking required language regarding rescission.

The arbitrator found the SDN valid, noting the applicant was represented by counsel at the time and understood the terms.

The issue of whether the applicant was time-barred from applying for mediation was deemed moot.

The applicant sought income replacement benefits and medical benefits following a motor vehicle accident.

The arbitrator found the applicant's testimony to be contradictory and lacking credibility, noting discrepancies regarding her medical treatment timeline, pre-existing injuries, and simultaneous receipt of Employment Insurance and income replacement benefits.

Relying on the medical evidence, including the insurer's orthopedic expert who found the applicant's pain was related to degenerative issues rather than the accident, the arbitrator concluded the applicant did not suffer a substantial inability to work.

All claims for benefits, a special award, and interest were dismissed.

The Applicant was injured in a motor vehicle accident and sought Income Replacement Benefits (IRBs) and Housekeeping and Home Maintenance Benefits from the Insurer.

The Insurer denied the claims.

At arbitration, the Applicant claimed he was self-employed prior to the accident and suffered a substantial inability to work and perform housekeeping tasks.

The Arbitrator found the Applicant's testimony lacked credibility and that he failed to provide sufficient evidence of pre-accident business income, as his tax returns showed only passive investment income.

Furthermore, medical evidence did not establish that his injuries were caused by the accident rather than extensive pre-existing conditions.

The Arbitrator dismissed the claims for IRBs, housekeeping benefits, and interest, finding the Applicant failed to meet his burden of proof.

The applicant sought accident benefits following a motor vehicle accident, claiming her injuries were catastrophic.

The arbitrator found the applicant lacked credibility, noting she had returned to work shortly after the accident, retrained for a more physically demanding job, and was observed on surveillance performing activities she claimed she could not do.

The arbitrator preferred the insurer's expert evidence over the applicant's, concluding the applicant failed to prove her injuries were catastrophic or that the claimed attendant care and medical benefits were reasonable, necessary, and directly caused by the accident.

All claims were dismissed.

The applicant fell from a ladder while installing security cameras and sought statutory accident benefits, claiming a vehicle struck his ladder.

The insurer argued it was a simple slip and fall.

With no witnesses and the applicant unable to remember the fall, the applicant relied on a forensic engineering expert who concluded the ladder's damage was caused by a vehicle's trailer hitch.

The arbitrator accepted the expert evidence, noting the insurer provided no rebuttal report, and found the incident met the definition of an 'accident' under Section 3(1) of the Schedule.

The applicant, a taxicab driver, sought statutory accident benefits after being assaulted by a passenger's companion.

After dropping off passengers and receiving payment, the applicant inadvertently bumped one of the passengers while reversing his taxi.

The passenger's companion then punched the applicant, causing severe injuries.

The arbitrator applied the two-part test to determine if the incident was an 'accident' under the Schedule.

The arbitrator found that the completion of the trip and the criminal assault were intervening acts that broke the chain of causation between the use of the vehicle and the injuries.

Therefore, the incident did not qualify as an accident.

The applicant failed to attend the scheduled arbitration hearing.

The applicant's counsel requested to be removed from the record due to a breakdown in the solicitor-client relationship, which was granted.

The insurer brought a motion to dismiss the application for arbitration.

After the applicant failed to respond to a post-hearing letter within 30 days, the arbitrator dismissed the application and awarded $500 in expenses to the insurer.

The applicant failed to attend her scheduled arbitration hearing for statutory accident benefits.

Her counsel attended and requested to be removed from the record due to a breakdown in the solicitor-client relationship, having lost contact with the applicant despite diligent efforts.

The arbitrator granted counsel's request to be removed.

The insurer brought a motion to dismiss the application for arbitration due to the applicant's non-attendance.

After providing the applicant 45 days to respond in writing, and receiving no response, the arbitrator dismissed the application.

The insurer sought expenses of $5,363.55, but the arbitrator awarded only $500.00 on compassionate grounds due to the applicant's advanced age.

The Applicant was injured in a motor vehicle accident and received Income Replacement Benefits (IRBs) until they were terminated by the Insurer.

The Applicant applied for arbitration six years after the termination, arguing the termination notice (OCF-9) was invalid because it directed her to contact an 'adjustor' while her file was handled by a 'claims representative'.

The Arbitrator found the notice was clear, unequivocal, and complied with the requirements set out in Smith v. Co-operators.

The Applicant's failure to dispute the termination within the two-year limitation period was not excused by the job title of the Insurer's employee.

The Applicant was held to be statute-barred from claiming IRBs, and the Insurer was awarded its expenses.

The Applicant sought additional post-104 Income Replacement Benefits (IRBs) following a motor vehicle accident.

The Insurer had deducted amounts from the IRBs based on the Applicant's self-employment income reported on his tax returns.

The Applicant argued that he was not employed as defined by the Schedule and that his tax returns were incorrect.

The Arbitrator found that the Applicant was self-employed during the period in dispute, as he continued to manage his rental properties and reported self-employment income on his tax returns.

The Arbitrator concluded that the Insurer correctly calculated the IRBs and dismissed the Applicant's claim for additional benefits and interest.

The Applicant sought accident benefits following a rear-end collision, claiming entitlement to attendant care benefits and the cost of an attendant care needs assessment.

The Insurer argued the Applicant's injuries fell within the Minor Injury Guideline (MIG).

The Arbitrator found that the Applicant failed to meet the burden of proving his injuries fell outside the MIG, relying on the Insurer's expert medical evidence.

Consequently, the Applicant was not entitled to attendant care benefits or the cost of the assessment.

The Applicant's claims were dismissed, and he was ordered to pay the Insurer's arbitration expenses.

The Applicant sought accident benefits for physiotherapy and massage therapy following a rear-end motor vehicle collision.

The Insurer denied the claims on the basis that the Applicant's injuries fell within the Minor Injury Guideline (MIG) and the treatment plans were unsigned.

The Arbitrator dismissed the Applicant's claims, finding that the Applicant failed to sign the OCF-18 treatment plans as required by section 38(3) of the SABS.

Furthermore, the Arbitrator accepted the Insurer's expert medical evidence that the Applicant's soft tissue injuries were treatable within the MIG and that the Applicant did not suffer from chronic pain.

The Insurer was awarded its expenses for the arbitration.

The applicant sought accident benefits following a motor vehicle accident.

The insurer denied the claims and mediation failed.

The applicant submitted an application for arbitration, which the insurer argued was time-barred under section 281.1(2)(b) of the Insurance Act.

The applicant claimed she had mailed the application within the limitation period, but it was misplaced by the Financial Services Commission of Ontario.

The arbitrator found no credible evidence that the application was submitted on time and dismissed the application as time-barred.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment based on psychological injuries, along with income replacement benefits and medical benefits.

The arbitrator preferred the evidence of the applicant's psychological expert, finding she suffered a marked impairment in her ability to adapt, and declared her catastrophically impaired.

The claim for income replacement benefits was dismissed due to an unexplained four-year delay in re-electing benefits.

The requested medical benefits for physiotherapy and psychological treatment were approved as reasonable and necessary.

The applicant sought income replacement benefits and medical benefits following a motor vehicle accident.

The applicant continued to work for two years post-accident before claiming income replacement benefits.

The arbitrator found the applicant's testimony lacked credibility and noted numerous contradictions.

The arbitrator dismissed the claims, finding the applicant failed to comply with the notice requirements under section 32 of the Schedule and failed to prove a substantial inability to perform the essential tasks of his employment.

The claim for medical benefits was also dismissed as the treatment plan was not shown to be reasonable or necessary.

The applicant failed to attend his scheduled arbitration hearing.

His counsel brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship and an inability to contact the applicant, which was granted.

The insurer requested that the application for arbitration be dismissed with costs.

The arbitrator dismissed the application due to the applicant's failure to attend and meet his onus of proof, and awarded $2,500 in expenses to the insurer.

The applicant sought interim accident benefits, including non-earner benefits, attendant care benefits, and medical/assessment benefits, following a motor vehicle accident.

The insurer denied the benefits.

The arbitrator found that the applicant had significant pre-existing physical and psychological conditions that were not proven to be exacerbated by the accident.

The arbitrator concluded that the applicant failed to demonstrate a compelling need or urgency for interim benefits, as he continued to receive medical treatment and had some assistance for his day-to-day needs.

The motion for interim benefits was dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming entitlement to medical benefits and income replacement benefits.

The insurer denied the claims, arguing the applicant was self-employed with no net profits and that her injuries did not warrant further treatment.

The arbitrator found the applicant lacked credibility and accepted the insurer's expert evidence that her physical injuries had plateaued and her psychological issues were unrelated to the accident.

The arbitrator also determined the applicant was self-employed and had no profits, resulting in an income replacement benefit calculation of zero.

The application was dismissed, and the insurer was awarded its expenses.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which the insurer denied.

The central issue was whether the applicant's injuries met the threshold for catastrophic impairment.

The arbitrator preferred the evidence of the applicant's experts, finding that the applicant suffered a marked psychological impairment and significant physical impairments, rendering her catastrophically impaired.

The arbitrator awarded various medical benefits, attendant care benefits, housekeeping and home maintenance benefits, and the costs of several assessments.

Claims for a driver desensitization assessment, a worksite assessment, and a special award were dismissed.

Interest was awarded on overdue payments.

Following an arbitration where the insurer successfully defended all claims for accident benefits, the insurer sought its expenses.

The arbitrator found the insurer was completely successful and that the applicant had rejected a reasonable settlement offer and failed to comply with undertakings.

The arbitrator assessed the insurer's expenses, allowing most fees and disbursements but excluding the cost of a court reporter, and ordered the applicant to pay $19,488.18 in expenses.