Louise Barrington

The Applicant was injured in a motor vehicle accident in 2013 and sought statutory accident benefits from the Insurer, claiming he suffered a catastrophic impairment.

The Applicant had a history of severe pre-existing psychological and physical impairments from prior accidents in 2002.

The Insurer denied the catastrophic impairment designation and various medical benefits, arguing that any impairment was due to the pre-existing conditions.

The arbitrator found that the 2013 accident materially contributed to the Applicant's psychiatric condition, worsening his impairment to a Class 4 marked impairment in activities of daily living.

The arbitrator concluded the Applicant suffered a catastrophic impairment and awarded the disputed medical benefits and examination costs, finding them reasonable and necessary for pain relief and assessment.

The claim for a special award was dismissed, but the Insurer was ordered to pay the Applicant's arbitration expenses and interest on overdue benefits.

The applicant was injured as a pedestrian when struck by a transit bus, sustaining orthopaedic injuries and a mild traumatic brain injury.

She applied for non-earner benefits, medical benefits, and the cost of assessments, which the insurer denied.

The arbitrator found that the applicant's physical injuries, combined with resulting chronic pain, depression, and cognitive deficits, continuously prevented her from engaging in substantially all of her pre-accident activities.

The arbitrator awarded the non-earner benefits, the disputed medical benefits, and the costs of the neuropsychological assessments, but denied the applicant's request for a special award.

The applicant was seriously injured in a motor vehicle accident in Georgia and sought a determination that he sustained a catastrophic impairment under the Statutory Accident Benefits Schedule.

The parties' medical experts disagreed on the applicant's whole person impairment (WPI) rating, with the applicant's experts assessing it between 62% and 71%, and the insurer's experts assessing it between 48% and 51%.

The arbitrator preferred the evidence of the applicant's experts, finding that the applicant's physical and psychological impairments, when combined, exceeded the 55% threshold.

The arbitrator also found that the accident materially contributed to the applicant's impairments, including his atrial fibrillation and peripheral neuropathy, despite the insurer's arguments regarding pre-existing susceptibility.

The applicant was found to have sustained a catastrophic impairment.

The applicant sought accident benefits following a motor vehicle accident.

The insurer terminated income replacement benefits and sought repayment, alleging the applicant misrepresented her employment status.

The applicant failed to produce ordered employment records and did not attend the hearing.

Her counsel was permitted to withdraw due to a breakdown in the solicitor-client relationship.

The arbitrator dismissed the applicant's claims and ordered her to repay $18,914.29 in income replacement benefits, finding she wilfully misled the insurer about her work history.

The insurer was also awarded $3,500 in costs.

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

The insurer terminated her income replacement benefits and denied medical and rehabilitation benefits, maintaining for nearly three years that her injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the applicant suffered a substantial inability to perform her pre-accident employment and, post-104 weeks, a complete inability to engage in suitable employment due to chronic pain.

The arbitrator granted the claimed income replacement benefits, medical benefits, and costs of examinations.

Furthermore, the arbitrator awarded a $25,000 Special Award against the insurer, finding that it had unreasonably delayed and denied benefits by relying on patently flawed medical reports and ignoring credible evidence of the applicant's chronic pain.

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

The insurer denied several treatment plans and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The applicant argued his injuries had developed into chronic pain, taking him outside the MIG.

The arbitrator found the applicant provided compelling evidence of chronic pain, removing him from the MIG.

The arbitrator granted the claims for a functional abilities evaluation, chiropractic treatment, and certain assistive devices, finding them reasonable and necessary.

Claims for a social-emotional assessment and additional assistive devices were denied.

The arbitrator awarded interest on the overdue benefits but denied the applicant's request for a special award, finding the insurer's conduct was not unreasonable.

The insurer brought a preliminary issue motion arguing that the applicant's claim for non-earner benefits was statute-barred because she failed to apply for arbitration within two years of a clear and unequivocal denial.

The arbitrator found that the insurer's initial denial was premature and rendered ambiguous by subsequent contradictory communications and requests for further medical information.

The limitation period did not begin to run until a later, unequivocal denial was issued.

The motion was dismissed, and the claim was allowed to proceed.

The insurer brought a motion to dismiss or stay the applicant's arbitration for statutory accident benefits, arguing that the applicant was already pursuing a civil action in the Superior Court of Justice arising from the same motor vehicle accident.

The arbitrator applied the Wasiela factors to determine whether the concurrent proceedings should be permitted.

The arbitrator found that the civil action, while broader in scope, primarily dealt with coverage and priority disputes among insurers and did not address the specific medical benefits claimed in the arbitration.

Given the imminent arbitration hearing and the potential delay in the civil action, the arbitrator concluded that the arbitration did not unduly duplicate proceedings and dismissed the insurer's motion.

The applicant was injured in a motorcycle accident and sought statutory accident benefits from the insurer, claiming she suffered a catastrophic impairment due to a combination of physical injuries and severe psychological disorders (depression, PTSD, and chronic pain).

The arbitrator found that the applicant's combined physical and psychological impairments met the 55% whole person impairment threshold, qualifying her for catastrophic impairment status.

The arbitrator also found the applicant suffered a complete inability to carry on a normal life, entitling her to ongoing non-earner benefits.

Claims for a specialized hospital bed and certain rehabilitation expenses were granted, while claims for massage therapy, travel time, and a special award were denied.