Jeffrey Rogers

The insurer appealed an arbitrator's interim order requiring it to produce an engineering report, claiming the report was protected by litigation privilege.

The insurer also sought to remove the arbitrator for a reasonable apprehension of bias.

The Director's Delegate allowed the appeal in part, finding that the arbitrator erred in ordering production of the report because it was commissioned after the insured applied for mediation, establishing a prima facie right to litigation privilege.

However, the Delegate dismissed the request to remove the arbitrator, finding no reasonable apprehension of bias.

The insurer appealed an arbitrator's decision refusing to dismiss the arbitration.

The insurer argued the arbitration was a nullity because the insured person had died before the application for mediation was filed, and the executrix had not been formally appointed by a court as a litigation administrator.

The Director's Delegate dismissed the appeal, confirming that an executrix derives her authority from the will, not from the probate process, and therefore had the authority to instruct counsel to commence proceedings immediately upon the insured's death.

The fact that counsel was unaware of the death when filing the application did not diminish the executrix's authority.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2007.

The insurer denied claims for chiropractic treatment and a psychological assessment.

At the arbitration hearing, the applicant was the sole witness.

The arbitrator found the applicant lacked credibility, noting he deliberately obscured his medical history, including previous accidents and pre-existing conditions, and exaggerated the severity of the subject accidents.

Consequently, the arbitrator concluded the applicant failed to prove the accidents materially contributed to his claimed impairments.

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

The applicants sought statutory accident benefits following a motor vehicle collision.

The insurer denied further claims and sought repayment of benefits already paid, alleging that the collision was staged and the applicants wilfully misrepresented material facts.

At a preliminary issue hearing, the arbitrator found the applicants to be credible and concluded that any inconsistencies in their evidence were due to the ordinary fragility of memory rather than a conspiracy.

The arbitrator held that the applicants did not wilfully misrepresent material facts and dismissed the insurer's claims for repayment.

The applicant sought expenses following a successful arbitration for statutory accident benefits.

The arbitrator found the applicant's claimed fees of $77,340 and disbursements of $51,911.72 to be grossly excessive.

Applying a 3:1 ratio of preparation to hearing time and reducing the hearing time for unnecessary procedural indulgences, the arbitrator awarded $21,696 for fees.

Disbursements were reduced to $18,070.72 to comply with fixed maximums and reasonableness.

The insurer was awarded $800 for the costs of the expense hearing due to the applicant's fanciful bill of costs.

The net amount payable to the applicant was fixed at $38,966.72.

Following a decision awarding the applicant attendant care benefits, the parties sought a determination on the accrual date for interest and the quantum of arbitration expenses.

The Arbitrator held that interest on the attendant care benefits accrued from 10 business days after the applicant delivered an Assessment of Attendant Care Needs, rejecting the argument that the insurer's prior knowledge of the need triggered an earlier accrual date.

The Arbitrator awarded the applicant $73,515.94 in arbitration expenses, applying deductions for issues on which the applicant was unsuccessful and for certain unrecoverable disbursements.

The parties were ordered to bear their own expenses for the costs hearing.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits from his insurer.

The insurer terminated income replacement, attendant care, and housekeeping benefits, arguing the applicant was no longer disabled and had not sustained a catastrophic impairment.

The arbitrator found that while the applicant's physical injuries were largely resolved or pre-existing, the accident triggered a mental disorder (Adjustment Disorder/Major Depressive Disorder) that caused a marked impairment in the sphere of adaptation.

Consequently, the applicant was deemed catastrophically impaired.

The arbitrator ordered the insurer to pay ongoing income replacement benefits, finding the applicant met both the eligibility and disability tests.

The arbitrator also awarded ongoing housekeeping benefits at $90 per week and specific attendant care benefits, but dismissed the claims for assessment costs and a special award.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer.

After mediation failed, the applicant applied for arbitration.

The applicant's representative sought to be removed from the record due to a loss of contact and instructions from the applicant.

The applicant failed to attend the pre-hearing and the arbitration hearing.

The arbitrator granted the representative's motion to be removed from the record and dismissed the arbitration due to the applicant's failure to participate and present evidence.

The applicant was ordered to pay the insurer $500 in expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, claiming he sustained a catastrophic impairment due to a mental disorder.

The insurer argued the mental disorder was genetically based and not caused by the accident.

The Arbitrator found that the accident caused the applicant's mental disorders, which resulted in a marked impairment of his ability to function, meeting the definition of catastrophic impairment.

The applicant was awarded attendant care benefits at a reduced rate, as he did not require round-the-clock care.

Claims for Botox injections and a special award were dismissed.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The insurer disputed entitlement on the basis that the applicant was not injured in an 'accident' as defined in the Schedule.

The applicant failed to participate in the arbitration process and did not attend the hearing despite receiving proper notice.

The arbitrator dismissed the arbitration due to the applicant's failure to tender evidence and ordered the applicant to pay $500 in expenses to the insurer.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The insurer disputed entitlement on the basis that the applicant was not involved in an "accident" as defined in the Schedule.

The applicant failed to participate in the arbitration process and did not attend the hearing despite receiving proper notice.

The arbitrator dismissed the arbitration due to the applicant's failure to tender evidence and ordered the applicant to pay $500 in expenses to the insurer.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

Disputes arose and mediation failed.

The applicant applied for arbitration, but the insurer argued the application was filed beyond the two-year limitation period.

The arbitrator found that the application was filed more than 90 days after the mediator's report and more than two years after the insurer's refusals.

The arbitration was dismissed as time-barred, and the applicant was ordered to pay $1,500 in expenses to the insurer.

The applicant sought to revoke an order dismissing her application for arbitration regarding statutory accident benefits.

The original order was made after she failed to attend pre-hearings and the arbitration hearing because she was out of the country.

The applicant provided evidence that she was unable to travel back to Canada due to a high-risk pregnancy and lacked the means to contact her solicitors while abroad.

The arbitrator found that this information was not reasonably available at the time of the arbitration and that the most just result was to allow the matter to proceed on its merits.

The application to revoke the dismissal order was granted, and the parties were ordered to bear their own expenses.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer brought a motion to dismiss the arbitration on the basis that the applicant was entitled to workers' compensation benefits under the Workplace Safety and Insurance Act.

The Workplace Safety Insurance Appeals Tribunal had previously ruled that the applicant was entitled to workers' compensation benefits.

The arbitrator found that section 59(1) of the Statutory Accident Benefits Schedule precluded the applicant from receiving accident benefits and dismissed the arbitration.

The insurer was awarded expenses of $3,443.71.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After disputes arose, the applicant applied for arbitration but subsequently lost contact with her legal representative and failed to attend the pre-hearing and the hearing.

The arbitrator granted the representative's request to be removed from the record.

As the applicant failed to participate and presented no evidence, the arbitration was dismissed.

The insurer was awarded its expenses of $898.56.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer denied the claims.

The applicant applied for mediation and subsequently for arbitration.

The insurer raised a preliminary issue that the applications were filed beyond the limitation periods set out in the Insurance Act and the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant failed to comply with both the two-year limitation period to apply for mediation and the 90-day limitation period to apply for arbitration after the mediator's report.

The application for arbitration was dismissed.

The applicant applied for arbitration regarding statutory accident benefits following a motor vehicle accident.

The applicant failed to attend the pre-hearing and the arbitration hearing.

The applicant's solicitor attended the hearing to request removal from the record, but the arbitrator denied the request because the applicant was not given proper notice.

As the applicant failed to attend and tender evidence to prove entitlement to the claimed benefits, the arbitration was dismissed.

The applicant applied for statutory accident benefits, claiming he was injured when the car he was a passenger in was rear-ended.

The insurer denied further benefits and sought repayment of paid benefits, alleging the accident was staged.

The arbitrator accepted expert collision reconstruction evidence that the vehicle damage was inconsistent with a rear-end collision and instead consistent with striking a pole.

Finding that the reported accident did not occur, the arbitrator dismissed the application and ordered the applicant to repay $5,971.83 in benefits due to wilful misrepresentation, along with $4,937.77 in arbitration expenses.

The applicants applied for statutory accident benefits following a motor vehicle accident.

The arbitration hearing was scheduled but the applicants failed to attend on two occasions without providing a reason.

The arbitrator dismissed the applications for arbitration due to the applicants' failure to present evidence.

The insurer sought expenses, including a claim that the applicants' paralegal representative be held personally liable.

The arbitrator awarded the insurer $2,000 in expenses payable by the applicants, but found no grounds to hold the representative personally liable.

The representative's motion to be removed from the record due to a breakdown in the solicitor-client relationship was granted.

The applicant sought statutory accident benefits following a motor vehicle accident.

After productions revealed the applicant had been involved in a subsequent accident and received income replacement benefits from another insurer—inconsistent with his claims in this arbitration—his representatives, Pace Law Firm, brought a motion to be removed from the record.

The applicant failed to attend the hearing.

The arbitrator granted the motion to remove Pace Law Firm due to a breakdown in the solicitor-client relationship.

As the applicant presented no evidence to support his claims, the arbitration was dismissed.

The insurer was awarded $1,500 in expenses.