Maggy Murray

Following a 17-day arbitration hearing where the insurer was completely successful in dismissing the applicant's claims for statutory accident benefits, the insurer sought its arbitration expenses.

The arbitrator reviewed the criteria under Rule 75.2 of the Dispute Resolution Practice Code, noting the insurer's complete success.

The arbitrator reduced the claimed hours to a reasonable amount and deducted $5,000 because the insurer unnecessarily prolonged the hearing by opposing a motion to redact solicitor-client privileged information.

The applicant was ordered to pay the insurer's expenses fixed at $32,000 inclusive of fees, disbursements, and HST.

Following a successful arbitration where the applicant's claims for caregiver benefits were dismissed, the insurer sought its arbitration expenses.

The arbitrator reviewed the criteria under Rule 75.2 of the Dispute Resolution Practice Code, noting the insurer's complete success, the applicant's failure to beat the insurer's settlement offer, and the applicant's improper conduct in resisting production of records.

The arbitrator awarded the insurer $18,000.00 in expenses, inclusive of legal fees calculated at Legal Aid rates and disbursements including court reporter fees.

The applicant sought non-earner benefits, medical and rehabilitation benefits, and a special award following a 2012 motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant lacked credibility due to numerous inconsistencies, misrepresentations, and evidence of symptom exaggeration.

The arbitrator placed little weight on the applicant's treating practitioners, preferring the evidence of the insurer's assessors who conducted more thorough document reviews and found the applicant did not suffer a complete inability to carry on a normal life and that the proposed treatments were not reasonable and necessary.

The applicant sought weekly caregiver benefits following a 2010 motor vehicle accident.

The insurer terminated benefits in September 2012.

The arbitrator found the applicant's evidence lacked credibility, noting numerous inconsistencies regarding her injuries, substance abuse, and the fact that her children had been removed from her care by Family and Children's Services in 2011 for reasons unrelated to the accident.

The arbitrator preferred the evidence of the insurer's assessors and concluded the applicant was not the primary caregiver at the time of the accident, did not suffer a complete inability to carry on a normal life, and did not incur the claimed caregiving expenses.

The application was dismissed.

The insurer appealed an Arbitrator's decision awarding the insured income replacement benefits and medical benefits following a motor vehicle accident.

The insurer argued the Arbitrator failed to apply the 'but for' test for causation, misapprehended evidence, and awarded costs for treatment plans he found unreasonable.

The Director's Delegate dismissed most of the appeal, finding the Arbitrator properly applied the causation test and assessed credibility.

However, the appeal was partially allowed regarding specific treatment plans where the Arbitrator made findings of fact unsupported by evidence.

The insured's cross-appeal for the cost of two surgeries in Florida was dismissed because the treatment plans were not signed by a regulated health professional in Ontario and were submitted after the surgeries had already occurred.

Wawanesa appealed an arbitration expenses order awarding the respondent $46,918.59 in legal costs following a successful claim for statutory accident benefits.

The Director's Delegate dismissed the appeal, finding that the insurer's submissions focused on the Arbitrator's findings of fact and exercise of discretion, which are entitled to significant deference and not subject to review absent an error of law.

The Arbitrator's decision was affirmed, and Wawanesa was ordered to pay $3,000 in appeal costs.

The appellant insured's appeal regarding catastrophic impairment and income replacement benefits was previously dismissed.

The successful respondent insurer sought its appeal costs in the amount of $18,742.02.

The Director's Delegate reviewed the criteria under Rule 75.2 of the Dispute Resolution Practice Code, noting that the overriding consideration in fixing arbitration expenses is reasonableness.

Finding the claimed lawyer hours excessive for a non-complex appeal and the transcript costs unrecoverable, the Director's Delegate fixed the insurer's appeal expenses at $4,000.00 inclusive of disbursements and HST.

The appellant appealed an Arbitrator's decision denying her claims for catastrophic impairment, attendant care, caregiver, medical, and housekeeping benefits following a 2009 motor vehicle accident.

The appellant argued the Arbitrator provided inadequate reasons, applied incorrect legal tests for burden of proof and causation, and erred in weighing evidence and assessing credibility.

The Director's Delegate dismissed the appeal, finding that the Arbitrator's reasons were adequate, the correct legal tests were applied, and the credibility findings were supported by ample evidence.

The Arbitrator's decision was confirmed and costs of $3,390 were awarded to the respondent.

The insurer, having successfully defended an appeal regarding statutory accident benefits, sought over $41,000 in appeal expenses.

The Director's Delegate found the claimed legal fees and disbursements to be excessive and unreasonable, noting that the appeal was not complex and did not require five different legal professionals.

Applying the criteria under Rule 75.2 of the Dispute Resolution Practice Code, the Director's Delegate fixed the insurer's appeal expenses at $5,000 inclusive of disbursements and HST.

The appellant appealed two arbitration orders denying her claims for non-earner benefits, medical benefits, and a special award, and ordering her to pay HST on the insurer's disbursements.

The Director's Delegate dismissed the appeal, finding no errors of law.

The Arbitrator correctly applied the test for non-earner benefits, properly concluded medical benefits were not incurred, and correctly applied the legislative requirement that treatment plans be signed.

The Delegate also refused to admit a new invoice as fresh evidence because it could have been adduced at the arbitration hearing.

Finally, the Delegate upheld the order requiring the appellant to pay HST on expert witness disbursements.

The appellant insurer appealed an arbitrator's decision awarding the respondent pedestrian non-earner benefits, medical expenses, cost of examinations, and arbitration expenses following a motor vehicle accident.

The Director's Delegate dismissed the appeal, finding that the insurer's grounds of appeal essentially disputed the arbitrator's findings of fact and weighing of evidence, rather than raising questions of law.

The Delegate affirmed that the arbitrator properly compared the respondent's pre- and post-accident life, correctly applied the burden of proof, and was entitled to rely on the testimony of the respondent and her daughter.

The appeal was dismissed with $10,000 in costs awarded to the respondent.

The insurer appealed a decision but subsequently abandoned the appeal on consent of the parties.

The Director's Delegate ordered the appeal dismissed and directed the insurer to pay the respondent's legal appeal expenses in the amount of $3,643.72, inclusive of disbursements and HST.

Aviva appealed an arbitrator's decision that found the claimant was entitled to a medical benefit of $1,822.04 for an occupational therapy assessment.

Aviva argued the arbitrator misinterpreted the Schedule, failed to provide adequate reasons, improperly refused to qualify its doctor as an expert, and made findings of fact without evidence.

The Director's Delegate dismissed the appeal, finding the arbitrator correctly applied the law, provided sufficient reasons, properly exercised discretion in not qualifying the expert, and made factual findings supported by evidence.

Aviva was ordered to pay $7,500 in costs.

The appellant appealed a decision to the Director of Arbitrations.

On consent of the parties, the Director's Delegate ordered the appellant to pay the respondent its legal expenses for the appeal proceedings in the amount of $1,531.34, inclusive of disbursements and HST.

The appellant, Mohammad Rafi, appealed a decision to the Director of Arbitrations.

On consent of the parties, the Director's Delegate ordered the appellant to pay the respondent, Aviva Canada Inc., its legal expenses for the appeal proceedings in the amount of $1,317.58, inclusive of disbursements and HST.

Aviva Canada appealed an arbitrator's decision finding that the claimant's injuries fell outside the Minor Injury Guideline (MIG) due to a diagnosis of chronic pain.

The Director's Delegate allowed the appeal, holding that the arbitrator erred in law by failing to apply the proper test from Scarlett.

Specifically, the arbitrator did not analyze whether the chronic pain was a 'clinically associated sequela' of the initial minor soft tissue injuries.

The Delegate substituted an order finding the injuries fell within the MIG.

A secondary ground of appeal regarding the late admission of expert reports was dismissed because Aviva had elected to proceed with the hearing rather than adjourn.

The appellant appealed an arbitrator's decision dismissing his claims for income replacement benefits and housekeeping expenses, and ordering him to pay $49,982.10 in costs to the respondent insurer.

The Director's Delegate found that the arbitrator's conclusions were based on factual findings regarding the appellant's lack of credibility and failure to provide reliable evidence of pre-accident employment and housekeeping expenses.

The Delegate held that there were no errors of law in the arbitrator's substantive findings, costs award, or procedural rulings.

The appeal was dismissed and the arbitrator's orders were confirmed.

The appellant appealed an Arbitrator's decision dismissing her claims for post-104 week income replacement benefits and a medical benefit for a physiotherapy treatment plan.

The Director's Delegate found that the Arbitrator failed to provide adequate reasons for his decision, which constituted a breach of natural justice and procedural fairness.

The Arbitrator ignored, failed to summarize, analyze, or consider important evidence that was not supportive of the insurer's position, and misinterpreted other evidence.

The appeal was allowed, the decision rescinded, and the matter returned to arbitration for a fresh hearing before a different arbitrator.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including income replacement, attendant care, and housekeeping benefits.

The insurer denied the claims.

The arbitrator dismissed all of the applicant's claims, finding that the applicant lacked credibility and failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his employment or his housekeeping tasks.

The arbitrator also found that the applicant's wife did not sustain an economic loss to justify the attendant care and housekeeping claims.

Claims for a special award and interest were consequently dismissed.

The appellant appealed an arbitrator's decision dismissing her claims for post-104 week income replacement benefits and a medical benefit for a physiotherapy treatment plan.

The Director's Delegate allowed the appeal, finding that the arbitrator failed to provide adequate reasons for his decision and failed to fairly consider the evidence from both parties.

The arbitrator ignored or misinterpreted significant evidence from several experts, including those retained by the insurer, whose opinions supported the appellant's claims.

The matter was returned to arbitration for a fresh hearing before a different arbitrator.