K. Julaine Palmer

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

The parties disputed the calculation of her weekly income benefit.

The arbitrator determined that vacation pay should be included in the calculation of gross weekly income, but severance pay received pursuant to the Employment Standards Act should not be included, as it is not a payment for loss of income.

The applicant's weekly income benefit was set at $207.63.

The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer.

The insurer terminated benefits, and the applicant sought arbitration, claiming he had a legitimate offer of employment prior to the accident that would entitle him to higher benefits.

The arbitrator found that the applicant and his witness fabricated the employment offer and related evidence.

The applicant was only entitled to the minimum weekly benefit, resulting in an overpayment of $16,108.80, which he was ordered to repay.

The arbitrator also found the arbitration to be frivolous and vexatious, denied the applicant's expenses, and ordered him to pay the insurer's $1,000 assessment fee.

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits for transportation, chiropractic, and prescription expenses.

The Insurer disputed the transportation mileage claimed and raised the issue of the Applicant's extended health coverage for chiropractic expenses.

The Arbitrator allowed transportation expenses only for the distance between the Applicant's office and the chiropractor, finding the remaining claimed mileage unreasonable.

The Insurer admitted liability for the chiropractic and prescription expenses, subject to the Applicant repaying any amounts received from his extended health insurer.

The claim for interest was dismissed due to insufficient evidence of when completed applications were submitted.

The issue of expenses was reserved.

The Applicant was injured in a motor vehicle accident while a passenger in a tractor driven by a co-worker.

The Insurer denied statutory accident benefits on the basis that the Applicant knew or ought to have known the vehicle was being driven without the owner's consent.

The arbitrator found that the employer had given the employees keys to the tractor without specific restrictions, implying authority to operate it.

Therefore, the driver had implied consent, and the Applicant was not precluded from receiving benefits under section 17(3)(b) of the Schedule.

The Applicant was injured in a motor vehicle accident in July 1990 and received weekly benefits until November 1991.

She was involved in a second accident in October 1991.

The Insurer terminated benefits for the first accident in November 1991.

The Applicant applied for mediation in June 1994 and arbitration in October 1994.

The arbitrator held that the application for arbitration was brought outside the two-year limitation period prescribed by the Insurance Act and the Statutory Accident Benefits Schedule, and therefore the Applicant could not proceed to arbitration for the first accident.

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

He later suffered a back injury while playing tennis and claimed this was an exacerbation of his accident-related injuries, seeking further income replacement benefits.

The arbitrator found that the applicant's own testimony was insufficient to establish causation between the motor vehicle accident and the subsequent back injury.

The claims for ongoing benefits and a special award were dismissed, though the applicant was awarded the costs of the arbitration.

The Applicant was injured in a motor vehicle accident and applied for statutory accident benefits, claiming weekly benefits for a substantial inability to perform essential tasks and supplementary medical and rehabilitation expenses.

The arbitrator found that while the Applicant suffered intermittent low back pain from the accident, it did not cause a substantial inability to perform her essential tasks, especially given her pre-existing medical conditions and sedentary lifestyle.

The claim for weekly benefits was dismissed.

The arbitrator allowed a portion of the claimed supplementary medical and rehabilitation expenses, awarding $816.38, and awarded the Applicant her expenses of the arbitration.

The applicant was injured in a motor vehicle accident and received weekly income benefits until December 1993.

He claimed entitlement to further benefits after suffering a back injury while playing tennis in August 1993, which he alleged was an exacerbation of his accident injuries.

The arbitrator found insufficient evidence linking the subsequent back pain to the motor vehicle accident.

The claims for ongoing weekly income benefits and a special award were dismissed, though the applicant was awarded his arbitration expenses.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated weekly income benefits.

The applicant sought arbitration for ongoing income benefits and rehabilitation expenses.

The arbitrator found that the applicant's wrist injury prevented him from performing his pre-accident heavy manual labour as a pool installer, entitling him to income benefits up to the 156-week mark.

Furthermore, the arbitrator concluded that the injury continuously prevented the applicant from engaging in any employment for which he was reasonably suited by education, training, or experience, entitling him to post-156 week benefits.

The arbitrator also awarded rehabilitation benefits and arbitration expenses.

The Applicant was injured in a motor vehicle accident and received statutory accident benefits, as well as private disability insurance benefits.

The Insurer terminated her weekly income benefits 156 weeks after the accident, arguing that the 156-week period under section 12(5) of the Statutory Accident Benefits Schedule ran continuously from the date of the accident.

The arbitrator held that the 156-week period refers to 156 weeks of payments made by the Insurer, not 156 weeks from the accident or 156 weeks of disability.

Because the Insurer had not yet paid 156 weeks of benefits (due to the private insurance payments), the Applicant was entitled to further weekly income benefits.

The claim for a special award was dismissed, as the Insurer's interpretation was not unreasonable in this case of first impression.

The applicant was injured in a motor vehicle accident and sought reinstatement of weekly income benefits, arguing she was on a 'temporary lay-off' from her work as a real estate salesperson and thus entitled to benefits under section 12 of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant had resigned from her position 15 months prior to the accident, actively sought other employment, and was therefore unemployed rather than on a temporary lay-off.

The claim for interim benefits was also denied due to a lack of medical evidence.

The applicant's entitlement to benefits will be considered under section 13 of the Schedule at a continuation of the hearing.

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

The parties disputed entitlement to weekly income benefits for a four-week period, supplementary medical and rehabilitation expenses, and a special award.

The arbitrator found the Applicant was entitled to the weekly income benefits, which the Insurer conceded partway through the hearing.

The arbitrator also awarded partial housekeeping, babysitting, and dental expenses, but denied transportation and optical expenses.

A special award was granted under section 282(10) of the Insurance Act due to the Insurer's unreasonable delay in paying the weekly income benefits and certain housekeeping expenses.

The Applicant was injured in a motor vehicle accident and received weekly income benefits until the Insurer terminated them.

The Applicant sought ongoing benefits, while the Insurer sought repayment of benefits paid, alleging fraud.

The arbitrator found that the Applicant was capable of working in his family cleaning business and had exaggerated his injuries, as evidenced by surveillance video and inconsistent testimony.

The arbitrator concluded the Applicant did not suffer a substantial inability to perform his essential tasks and ordered him to repay $36,474.84 in benefits obtained through fraud.

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

The insurer refused to pay for chiropractic treatments after July 30, 1993, arguing they were no longer reasonable or necessary.

The arbitrator found that the ongoing chiropractic care constituted therapeutically necessary supportive care rather than elective maintenance care, given the physical demands of the applicant's work.

The arbitrator also ruled that while the insurer had no statutory right to require a medical examination for a claim involving only medical and rehabilitation benefits, the resulting medical report was admissible because the applicant attended voluntarily.

The insurer was ordered to pay the outstanding chiropractic and transportation expenses, plus the costs of the arbitration.

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits for moving and snow clearing expenses.

The insurer paid a portion of the moving expenses but denied the rest.

The arbitrator found that the applicant required assistance with moving and snow clearing due to his injuries.

The arbitrator awarded $70 for snow clearing and a portion of the moving expenses, deducting the estimated cost the applicant would have incurred had he moved himself.

The claim for a special award was dismissed as the insurer had not unreasonably withheld payments.

The applicant, a minor who suffered severe injuries after being struck by a motor vehicle, applied for statutory accident benefits from two insurers.

Allstate paid benefits to date, while York Fire denied liability.

On a preliminary issue hearing, the arbitrator ordered both insurers to share equally in the payment of interim benefits pending the final arbitration to determine priority.

The arbitrator found jurisdiction to make interim orders under section 279(4.1) of the Insurance Act and held that the applicant established a prima facie case for entitlement and urgency.

The Applicant was injured in a motor vehicle accident and sought weekly benefits and child care benefits under the Statutory Accident Benefits Schedule.

The Insurer terminated benefits, and the parties proceeded to arbitration.

The arbitrator found that while the Applicant suffered pain and had to modify her activities, she was not substantially unable to perform her essential tasks as a homemaker.

The claim for further weekly benefits was dismissed, though the Applicant was awarded her expenses for the arbitration.

The applicant applied for arbitration on behalf of his granddaughter, claiming death benefits following the death of her father in a motor vehicle accident.

The insurer denied the claim on the basis that the child's mother was a separated common-law spouse and not a 'spouse at the time of the accident'.

The arbitrator held that the child was a dependant under the Schedule because she was principally dependent on the deceased's spouse, regardless of whether the spouse qualified for a spousal death benefit.

The arbitrator awarded $35,000 in death benefits to the child, finding that denying benefits to children of unmarried parents would be unfair and contrary to the Children's Law Reform Act.

The applicant was injured in a motor vehicle accident in November 1991 and received statutory accident benefits until July 1992.

She applied for arbitration seeking ongoing weekly income benefits and housekeeping expenses, claiming she was substantially unable to perform her essential tasks.

The arbitrator found that the applicant suffered from chronic pain syndrome resulting from a prior 1989 accident, and that the 1991 accident only caused a minor exacerbation that had resolved by July 1992.

The claims for ongoing weekly income benefits and housekeeping expenses were dismissed, as the ongoing symptoms were not causally connected to the 1991 accident.

The applicant was awarded her arbitration expenses.

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

The Insurer terminated weekly income benefits on March 31, 1993.

The Applicant sought arbitration for further weekly income benefits, supplementary medical and rehabilitation expenses, and housekeeping and child care expenses.

The arbitrator found that the Applicant was not substantially unable to perform her essential tasks and dismissed the claim for further weekly income benefits.

The arbitrator awarded certain supplementary medical and rehabilitation expenses, including transportation and a club membership, but denied the claim for housekeeping and child care expenses due to insufficient evidence.