K. Julaine Palmer

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

A dispute arose regarding the correct calculation of his pre-accident income from self-employment.

The arbitrator found that the applicant failed to provide sufficient documentation to prove his net income exceeded the minimum threshold, entitling him only to the minimum benefit of $185.60 per week.

Consequently, the insurer was entitled to repayment of $15,951.51 in overpaid benefits, while the applicant was awarded his arbitration expenses.

The applicant, a taxi driver, was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them.

The applicant sought arbitration to reinstate the benefits and increase the weekly rate.

The arbitrator found that the applicant had a significant pre-existing back condition (ankylosing spondylitis) which he had concealed from medical examiners.

Due to inconsistencies and false evidence regarding his post-accident employment and pre-accident income, the arbitrator concluded the applicant failed to prove a substantial inability to perform his essential tasks.

The claim for further benefits was dismissed, the weekly rate was maintained at the statutory minimum, and no costs were awarded to either party.

The applicant was injured in a rear-end motor vehicle accident and received weekly income benefits until the insurer terminated them.

The applicant sought arbitration, claiming she suffered from post-traumatic fibromyalgia and was substantially unable to perform her essential job tasks as an assembler.

The arbitrator reviewed medical evidence and surveillance video, concluding that the applicant's job was light and sedentary, and that she had adopted a dysfunctional stance, magnifying her symptoms.

The arbitrator found that any continuing symptoms were not caused by the accident and dismissed the claim for ongoing weekly income benefits and a special award, but granted the applicant her arbitration expenses.

The Applicant was seriously injured in a motor vehicle accident while a passenger in a vehicle driven by an unauthorized driver.

The Insurer denied statutory accident benefits, arguing the Applicant knew or ought reasonably to have known the driver lacked the owner's consent under section 17(3)(b) of the Statutory Accident Benefits Schedule.

The arbitrator found no evidence that the Applicant, who was highly intoxicated and suffered a severe head injury, knew or ought reasonably to have known the driver lacked consent.

The exclusion did not apply, and the Applicant was entitled to his arbitration expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits to purchase a new, 'safe' vehicle to treat her severe car phobia, which had been exacerbated by the accident.

The insurer refused to fund the vehicle purchase.

The arbitrator found that while the applicant suffered a serious psychological injury that aggravated a pre-existing condition, the insurer's rehabilitation obligations did not extend to purchasing a new vehicle.

The insurer was only required to return the applicant to her pre-accident state, at which time she was already suffering from car phobia and had not been provided a new vehicle.

The claim for a vehicle was dismissed, but the applicant was awarded her arbitration expenses.

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

The parties disputed the amount payable to the Applicant's wife for caregiving services, the calculation of the Applicant's pre-accident income, and whether collateral benefits should be deducted on a net or gross basis.

The Arbitrator awarded $17,208 for care benefits based on a minimum wage rate, plus a visiting allowance.

The Arbitrator also determined the Applicant's pre-accident income by averaging his earnings over the 52 weeks prior to the accident and held that collateral benefits must be deducted from weekly income benefits on a gross, rather than net, basis.

The applicants, two brothers, were injured in a motor vehicle accident and sought weekly income benefits from their insurer.

The insurer terminated benefits in the summer of 1992.

Following an arbitration hearing, the arbitrator determined the applicants' pre-accident weekly incomes and calculated their respective benefit amounts.

Based on medical and psychological evidence, the arbitrator found that one applicant was disabled from his job as a bodyshop helper until December 30, 1992, and the other was disabled from his job as a cleaner until April 30, 1993.

Claims for repayment by the insurer and a special award by the applicants were dismissed due to a lack of evidence.

The applicants were awarded their arbitration expenses.

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

The Insurer terminated benefits, arguing the Applicant was not employed or on a temporary lay-off at the time of the accident.

The arbitrator found that the Applicant, who had been laid off due to a shortage of work but maintained a reasonable expectation of recall, was on a temporary lay-off at the time of the accident.

The Applicant was deemed eligible for benefits and awarded arbitration expenses.

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

The applicant brought a preliminary motion seeking interim reinstatement of benefits and challenging the insurer's right to require medical examinations by multiple practitioners after terminating benefits.

The arbitrator held that the insurer may require examinations under section 23(2) of the No-Fault Benefits Schedule even after terminating benefits, and that the Schedule permits examinations by more than one qualified medical practitioner.

The arbitrator also found no statutory authority to grant an interim order reinstating weekly income benefits pending the final disposition.

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

More than two years after the termination, the Applicant applied for arbitration.

The Insurer raised a preliminary issue that the application was time-barred under section 281(5) of the Insurance Act.

The arbitrator found no discretion to extend the limitation period and held that the relief from forfeiture provision in section 129 did not apply to non-compliance with a time-limit to commence an action.

The application was dismissed as time-barred, and no expenses were awarded to the Applicant.

The applicant, a Manitoba resident, was injured in a motor vehicle accident in Ontario while driving a vehicle insured by the Saskatchewan Government Insurance Office (SGIO).

The applicant applied for no-fault benefits under the Ontario Insurance Act, but SGIO refused to pay, arguing it was not liable under Saskatchewan law.

The arbitrator held that SGIO was bound by a Power of Attorney and Undertaking it had signed, which precluded it from setting up a defence that would not be available to an Ontario insurer.

Consequently, SGIO was found liable to pay no-fault benefits to the applicant.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them based on surveillance video showing him moving furniture.

The applicant applied for arbitration.

The arbitrator found that the applicant, a heavy equipment operator, remained substantially unable to perform his essential tasks and reinstated the $600 weekly benefits.

The arbitrator also found the insurer acted unreasonably in terminating benefits without further medical investigation or discussing the video with the applicant, awarding a $2,000 special award to the applicant.

The applicant, a limousine driver, was kidnapped at gunpoint in his vehicle and forced to drive into the countryside before the vehicle was stolen.

He suffered psychological injuries and applied for accident benefits.

The insurer denied the claim, arguing the incident did not involve the use or operation of an automobile.

The arbitrator found that the forced operation of the vehicle at gunpoint directly or indirectly caused the psychological injury, satisfying the definition of an accident under the No-Fault Benefits Schedule.

The applicant was awarded $3,600 in weekly income benefits and his arbitration expenses.

The applicant, a self-employed restaurant owner, was injured in a motor vehicle accident and received weekly income benefits from the insurer until December 1992.

He applied for arbitration seeking ongoing benefits.

The arbitrator found that the applicant was no longer substantially disabled from performing the essential tasks of his occupation after December 1992, relying on extensive medical and rehabilitation evidence.

Furthermore, the arbitrator determined that the applicant had failed to prove his pre-accident income was higher than the deemed minimum, resulting in a finding that the insurer had significantly overpaid him.

The insurer was ordered to be repaid $28,593.60, and the applicant's claim for a special award was dismissed.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until they were terminated by the insurer.

The parties reached a settlement at mediation, but the applicant subsequently sought to invalidate the agreement, arguing the insurer failed to disclose a rehabilitation consultant's report prior to the settlement.

The arbitrator held that the report contained no information that would render the settlement unconscionable and upheld the validity of the mediation agreement.

The applicant was awarded expenses for the preliminary issue hearing.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them, asserting she no longer qualified.

The applicant sought arbitration to reinstate the benefits under section 13(1) of the No-Fault Benefits Schedule.

The arbitrator found that while the applicant continued to suffer pain and her ability to perform certain activities was impaired, she did not suffer a "substantial inability" to perform her "essential tasks" as she continued to perform nearly all her previous activities.

The claim for further weekly income benefits was dismissed, but the applicant was awarded her arbitration expenses and the insurer agreed to pay $513.00 in supplementary medical and rehabilitation expenses.

The applicant, a taxicab driver, was injured in a motor vehicle accident and subsequently developed post-traumatic stress disorder and a driving phobia.

The insurer terminated her weekly income benefits, arguing she had returned to her pre-accident condition.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her occupation due to the psychological injuries caused by the accident.

However, because the applicant fabricated trip sheets to inflate her pre-accident income, the arbitrator awarded the minimum weekly benefit of $185.60 and reduced her expense award to two-thirds.

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

He sought weekly income benefits under section 12 of the No-Fault Benefits Schedule, arguing he was self-employed at the time of the accident despite receiving workers' compensation for a prior injury.

The arbitrator found that the Applicant was neither employed nor self-employed in the twelve months prior to the accident, making him ineligible under section 12.

He was found entitled to benefits under section 13 at $185.00 per week.

The arbitrator declined to rule on the deductibility of workers' compensation benefits due to a lack of jurisdiction, as the issue had not been mediated.

The applicant was injured in a motor vehicle accident and applied for arbitration after the insurer terminated his weekly income benefits.

At the opening of the arbitration hearing, the applicant withdrew his application, stating he wished to pursue the matter in court.

The insurer sought a refund of its $1,000 assessment fee, and the applicant sought his expenses for the arbitration.

The arbitrator held that there is no statutory provision allowing for the refund of the insurer's assessment fee when an application is withdrawn.

The arbitrator also declined to award the applicant his expenses, finding that his withdrawal at the hearing was capricious and unreasonably prolonged the proceedings.

The Applicant sought weekly income benefits following a motor vehicle accident.

The Insurer terminated benefits, arguing the Applicant was no longer substantially unable to perform his employment tasks.

The Arbitrator found the Applicant to be highly unreliable, noting he had worked as a meat cutter for six weeks following the accident while claiming total disability, and had fabricated employment records.

Relying on the objective medical evidence and the Applicant's extensive pre-existing back issues, the Arbitrator concluded the Applicant was not significantly injured in the accident and was never entitled to the benefits received.

The Applicant was ordered to repay $25,660.07 to the Insurer.