Judith Killoran

The 80-year-old applicant was injured in a motor vehicle accident and sought payment for rehabilitation treatment at a clinic.

The insurer refused to pay the full cost, disputing the frequency of treatment and the hourly fees charged.

The arbitrator found that the treatment was reasonable and necessary given the applicant's age and medical history, rejecting the insurer's suggestion that she could exercise at home.

However, the arbitrator reduced the hourly rate charged by the clinic to the market rate for kinesiologists, awarding the applicant $3,655.41 plus interest.

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

The insurer terminated his income replacement benefits after he returned to work in a modified capacity.

The applicant applied for arbitration almost four years after the initial notice of termination.

The insurer argued the application was barred by the two-year limitation period under subsection 281(5) of the Insurance Act.

The arbitrator found that the insurer failed to comply with the mandatory notice requirements under sections 64 and 71 of the Statutory Accident Benefits Schedule when it stopped paying benefits.

Because the insurer did not provide proper notice of the right to dispute, the limitation period did not begin to run.

The applicant was not precluded from proceeding to arbitration.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them after the 156-week mark.

The applicant sought ongoing benefits under subsection 12(5)(b) of the Statutory Accident Benefits Schedule, arguing she was continuously prevented from engaging in suitable employment.

The arbitrator found that the applicant lacked the physical capacity to return to her former physically demanding jobs and lacked the skills for sedentary office work without further retraining.

The arbitrator ordered ongoing weekly income benefits.

Additionally, the arbitrator awarded a $10,000 special award under section 282(10) of the Insurance Act because the insurer unreasonably terminated benefits without proper notice or justification.

The applicant sought her expenses following an arbitration decision regarding statutory accident benefits.

The insurer agreed the applicant was entitled to expenses but disputed the number of hours claimed by her counsel.

The arbitrator reviewed the bill of costs, noting the complexity and significance of the issues, as well as the multiple hearings and written submissions required.

The arbitrator reduced the claimed 144.85 hours to 120 hours, awarding $18,000 in legal fees and $1,688 in disbursements, plus applicable GST.

The applicant sought interim income replacement benefits after the insurer terminated them.

The arbitrator found that the insurer's termination of benefits was based on a flawed Designated Assessment Centre (DAC) process, which failed to comply with section 64 of the Statutory Accident Benefits Schedule.

The arbitrator also found that the applicant established a strong prima facie case for entitlement to benefits and demonstrated financial urgency.

The insurer was ordered to pay interim benefits of $313.77 per week, with the issues of a special award and expenses reserved for the main arbitration hearing.

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

The applicant failed to attend the arbitration hearing and had previously failed to provide requested medical and financial documentation or attend insurer examinations.

The arbitrator proceeded in the applicant's absence, dismissed the claims for benefits and a special award, and ordered the applicant to pay the insurer's arbitration expenses for unreasonably prolonging the proceedings.

The applicant sought to proceed to arbitration on claims for rehabilitation, housekeeping, and supplementary medical benefits.

The insurer argued these claims were statute-barred because a separate application for arbitration was not filed within the two-year limitation period following the refusal of benefits.

The arbitrator found that the applicant had complied with the spirit of the legislation, as the issues were mediated shortly after the application was filed and the insurer had clear notice of the claims.

The arbitrator ordered that all issues, including income replacement benefits, be heard together at the main arbitration hearing.

The applicant's spouse died from carbon monoxide poisoning while operating a Gravely tractor in an underground parking garage.

The applicant sought death benefits under a standard automobile policy.

The insurer denied the claim on the basis that the tractor was not an automobile.

The arbitrator applied the three-stage test from Regele v. Slusarczyk and found that the tractor was not an automobile in ordinary parlance, was not covered by the policy, and was not required to be insured under the Compulsory Automobile Insurance Act or the Off-Road Vehicles Act because it was not operated on a highway or off the owner's property.

The preliminary issue was resolved in favour of the insurer.

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

The insurer disputed the amount of legal fees, clerk fees, and certain disbursements.

The arbitrator awarded the applicant's counsel the maximum hourly rate of $150, finding the case was not straightforward and required significant preparation.

The arbitrator allowed a ratio of three hours of preparation for each hour of hearing for counsel, and two hours for the clerk, who also provided translation services.

The insurer was ordered to pay $19,200 for counsel fees, $4,320 for clerk fees, and $5,741.23 for disbursements.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them at the 104-week mark, offering a loss of earning capacity benefit of zero.

The arbitrator found that the insurer failed to follow the proper termination procedures under the Statutory Accident Benefits Schedule and did not arrange a residual earning capacity assessment in a timely manner.

The arbitrator ordered that the benefits payable after the termination date be characterized as income replacement benefits until 14 days after the receipt of a valid residual earning capacity assessment, after which loss of earning capacity benefits could commence.

A special award of 10 percent was granted due to the insurer's unreasonable withholding of benefits.

Following a preliminary issues hearing where the applicant was ordered to pay the insurer's expenses, the insurer sought $1,059.11 in costs.

The arbitrator found the preparation time claimed by the insurer to be somewhat excessive, reducing it from 9.1 hours to 5.1 hours.

The applicant was ordered to pay the insurer $757.59 in expenses for the preliminary issues hearing.

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

After failing to comply with multiple production orders and failing to attend the arbitration hearing, the arbitrator proceeded in his absence.

The applicant's claim for income replacement benefits was dismissed for lack of evidence.

The insurer's claims for repayment of benefits and a special award for a frivolous proceeding were also dismissed.

However, the arbitrator ordered the applicant to pay the insurer's expenses of $2,216.89 because his conduct, including failing to obey production orders and not attending the hearing, unreasonably prolonged the proceedings.

The applicant was injured in a motor vehicle accident and sought income replacement benefits, which the insurer terminated for insufficient documentation of pre-accident income.

At the arbitration hearing, the insurer brought a preliminary motion to dismiss the application, arguing the applicant failed to comply with a pre-hearing order to produce his complete WCB file, clinical notes, and banking records.

The arbitrator dismissed the motion, finding the applicant had not refused to comply but had provided the documents he intended to rely on, and declined to draw an adverse inference at the preliminary stage.

However, because the applicant's late production of voluminous records caused substantial delay, the arbitrator ordered the applicant to pay the insurer's expenses for the preliminary hearing.

The applicant sought her expenses for an arbitration hearing and the subsequent hearing on expenses, despite being unsuccessful in her claim for weekly statutory accident benefits.

The insurer argued that its offer to settle and the applicant's conduct should preclude an award of expenses.

The arbitrator found that the applicant's claim was not unreasonable and that her conduct did not disqualify her from entitlement to expenses.

The arbitrator emphasized the importance of accessibility to the dispute resolution system and awarded the applicant her expenses.

The applicant was injured in a motor vehicle accident and claimed entitlement to weekly income replacement benefits of $430.71 based on his income as an independent convenience store operator.

The insurer paid $238.07 weekly.

The arbitrator found the applicant's evidence regarding his employee wage costs to be inconsistent and unsupported by documentation.

The arbitrator accepted the insurer's expert accounting evidence, which calculated the applicant's net weekly income at $264.53, entitling him to a benefit of $238.07.

The claim for a special award was dismissed as the insurer had paid the proper amount.

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

The insurer terminated her caregiver and housekeeping benefits after she refused to attend multiple insurer examinations.

The applicant sought arbitration, arguing the requests for examinations were unreasonable and excessive.

The arbitrator found that the insurer failed to comply with section 65 of the Statutory Accident Benefits Schedule, as the number and length of the requested assessments were excessive and failed to consider the applicant's convenience or provide reasonable notice.

The arbitrator also found that the insurer unreasonably withheld and delayed benefits, ordering a special award of 50 per cent of the outstanding benefits plus interest, and awarded expenses to the applicant.

The applicant was injured in a motor vehicle accident and sought ongoing weekly income replacement benefits after the insurer terminated them.

The arbitrator found that the applicant, a coffee truck operator who suffered a severe shoulder injury requiring multiple surgeries, remained substantially unable to perform the essential tasks of his employment.

The arbitrator rejected the insurer's surveillance evidence and the report of its medical examiner, finding them unpersuasive.

The applicant was awarded ongoing income replacement benefits at $214.19 per week plus interest, but his claim for a special award was denied.

The applicant was injured in two motor vehicle accidents in 1993 and received statutory accident benefits until the insurer terminated them in January 1997.

The applicant sought ongoing weekly non-earner benefits, arguing that chronic pain and psychological factors continuously prevented her from engaging in substantially all of her pre-accident activities.

The arbitrator reviewed medical evidence from various experts, noting that while the applicant suffered from chronic pain and depression, her physical injuries had healed and she maintained normal muscle bulk, indicating a higher level of activity than she perceived.

The arbitrator concluded that the applicant did not meet the stringent post-156 week test under subsection 13(8)(b) of the Schedule, as her impairment did not continuously prevent her from engaging in substantially all of her former activities.

The application for weekly benefits was dismissed.

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

The applicant failed to appear at the arbitration hearing.

The arbitrator proceeded in the applicant's absence under the Statutory Powers Procedure Act.

Based on the insurer's evidence, which included surveillance and inconsistencies regarding the applicant's alleged employment, the arbitrator dismissed the claims for income replacement, medical, and housekeeping benefits.

The applicant was ordered to pay $3,000 in expenses to the insurer for prolonging and obstructing the proceeding.