Marshall Schnapp

The applicant filed two similar records cases against the respondent condominium corporation.

As both cases involved similar issues and one was in the early stages of the hearing process, the Tribunal proposed merging them in the interest of efficiency and fairness pursuant to Rule 18.2 of the Tribunal's Rules of Practice.

Both parties consented, and the Tribunal ordered the cases merged.

The Applicant was injured in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment due to a psychiatric disorder.

The arbitrator found that the Applicant's treating psychiatrist provided sufficient evidence of a Marked Impairment under the AMA Guidelines, satisfying the catastrophic impairment threshold.

The arbitrator also awarded a special award of $9,629.70 against the Insurer for unreasonably delaying the payment of income replacement benefits for 527 days without a valid reason, but denied a special award for medical and attendant care benefits.

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

The insurer denied the benefits, arguing that the applicant's ongoing impairments were caused by a subsequent slip and fall incident rather than the motor vehicle accident.

The arbitrator found the applicant credible and concluded that the motor vehicle accident rendered an asymptomatic condition symptomatic, making her vulnerable to subsequent flare-ups.

The arbitrator awarded income replacement benefits from March 2014 onwards and approved several treatment plans, but denied a special award, finding the insurer had not acted unreasonably given the complex medical evidence.

Following a decision that the arbitrator had no jurisdiction to order a special award regarding the handling of the applicant's claim for attendant care benefits, the insurer sought its expenses for the arbitration proceeding.

The arbitrator found that the insurer was the successful party and awarded expenses.

However, noting the lack of complexity and the consumer-oriented nature of the legislation, the arbitrator reduced the claimed hours and awarded the insurer 50% of its claimed expenses, fixing the amount at $5,580.14.

The applicant was injured in a motor vehicle accident and sought non-earner benefits, medical benefits, and the cost of examinations from the insurer.

The insurer denied the benefits.

At the arbitration hearing, the applicant's credibility was found to be questionable due to inconsistencies between his testimony and the medical documentation regarding his pre-accident and post-accident activity levels.

The arbitrator concluded that the applicant failed to prove on a balance of probabilities that he suffered a complete inability to carry on a normal life as a result of the accident.

The claims for medical benefits and cost of examinations were also dismissed as the applicant did not establish that they were reasonable and necessary.

The applicant was involved in motor vehicle accidents in May 2012 and October 2012, and sought statutory accident benefits from the insurer, including non-earner benefits, medical benefits, and the cost of examinations.

The insurer denied the claims.

The arbitrator found that the applicant was not entitled to a non-earner benefit because she failed to submit a Disability Certificate for the May 2012 accident, as required by section 36(3) of the Schedule.

Furthermore, the arbitrator concluded that the applicant did not prove she suffered a complete inability to carry on a normal life, as she continued to attend school, work part-time, and engage in other normal activities post-accident.

The claims for medical benefits and cost of examinations were also dismissed because the applicant failed to establish that they were reasonable and necessary.

The applicant was injured in a 2011 motor vehicle accident and sought payment for a $2,362.00 physical therapy treatment plan, a special award, and interest.

The insurer denied the treatment plan based on an independent physiotherapy assessment concluding the applicant had reached maximum therapeutic benefit.

The arbitrator found the treatment plan was reasonable and necessary, noting the applicant's complex pre-accident medical history and chronic pain, which required a longer course of treatment.

The arbitrator relied on credible testimony from the applicant, his mother, and treating practitioners showing functional deterioration when treatment ceased.

The claim for a special award was dismissed as the insurer relied on an expert opinion and did not act imprudently or inflexibly.

Interest was awarded on the overdue benefits.

The Applicant was injured in a motor vehicle accident and sought accident benefits from the Insurer.

The Insurer denied a $2,460.00 physiatry assessment, arguing the Applicant's injuries fell within the Minor Injury Guideline (MIG).

The Arbitrator found the assessment was reasonable and necessary, as the Applicant had significant pre-existing physical and psychological conditions, including PTSD, that prevented him from achieving maximum recovery within the MIG.

The Arbitrator ordered the Insurer to pay for the assessment and interest, but declined to order a special award, finding the Insurer's denial was not imprudent, stubborn, or inflexible given the circumstances.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to attend the arbitration hearing.

The arbitrator proceeded in the applicant's absence pursuant to Rule 37.7 of the Dispute Resolution Practice Code.

As the applicant bore the onus of proving entitlement and presented no evidence, the application was dismissed.

The insurer was awarded $500 in expenses.

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

The applicant later entered into a full and final settlement of the accident benefits claim with a priority insurer, which allocated no monies towards attendant care benefits.

The applicant then sought a special award against the original insurer for unreasonably withholding or delaying payments.

The arbitrator held that there is no jurisdiction to order a special award where the underlying claim for benefits has been resolved on a full and final basis without any finding or recognition of entitlement to benefits.

The application for arbitration was dismissed.

The applicant sought statutory accident benefits after falling in a nursery parking lot.

She claimed she was in the process of unlocking her vehicle when her leg became caught in strapping on the ground.

The insurer denied the claim, arguing the incident did not meet the definition of an 'accident' under the Schedule.

The Arbitrator found that the incident did not arise out of the use or operation of an automobile, as the evidence indicated she fell while turning away from returning a shopping cart, not while unlocking her vehicle.

Furthermore, the vehicle was not the direct cause of her injuries; the strapping on the ground was the intervening and dominant feature.

The application for arbitration was dismissed.

The applicant was injured in a motor vehicle accident when the bus he was on collided with a train, resulting in catastrophic impairments.

He sought ongoing attendant care benefits and a Special Award for the insurer's unreasonable delay in paying benefits.

The arbitrator found that the applicant was entitled to ongoing attendant care benefits at $6,000 per month, rejecting the insurer's argument that the applicant must continually prove the expenses were 'incurred' each month.

The arbitrator also awarded a Special Award, finding that the insurer acted unreasonably, imprudently, and inflexibly in delaying payments for attendant care and medical benefits despite having sufficient evidence of the applicant's economic loss and catastrophic impairments.

The applicant was involved in two motor vehicle accidents and filed two separate Applications for Arbitration for non-earner benefits.

The insurer brought a preliminary motion to dismiss the second application as frivolous, vexatious, and an abuse of process, arguing it duplicated the first.

The applicant requested that the two applications be combined.

The arbitrator found no evidence that the second application was an abuse of process, noting that the issue of benefits arising from the first accident had not yet been litigated.

The arbitrator ordered the two applications combined pursuant to Rule 30 of the Dispute Resolution Practice Code to ensure the most just, quickest, and least expensive resolution.

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

The applicant failed to attend the scheduled arbitration hearing.

The arbitrator proceeded in the applicant's absence pursuant to Rule 37.7 of the Dispute Resolution Practice Code.

As the applicant bore the onus of proving entitlement and presented no evidence, the application was dismissed.

The insurer was awarded expenses in the amount of $3,741.42.

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

The parties were unable to resolve their disputes through mediation, and the applicant applied for arbitration at the Financial Services Commission of Ontario.

At the hearing, the parties agreed on consent to dismiss the application for arbitration without costs.

The arbitrator ordered the application dismissed with no costs or expenses payable by either party.

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

After failing to attend multiple scheduled pre-hearing discussions, the applicant's representative sought to be removed from the record, and the insurer moved to dismiss the application.

The arbitrator found that the applicant had been given notice but chose not to participate, rendering the proceeding frivolous or vexatious.

The application was dismissed, the representative was removed, and the applicant was ordered to pay $500 in expenses to the insurer for needless delay.

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

The parties were unable to resolve their disputes through mediation, and the applicant applied for arbitration.

Prior to the hearing, the parties consented to the dismissal of the application for arbitration without costs.

The arbitrator dismissed the application and ordered no costs.

A resident filed a complaint alleging that the Mayor violated the Code of Conduct and the procedural by-law by participating as an ex-officio member of the Multiplex Task Force.

The Integrity Commissioner found that the procedural by-law was ambiguous regarding which committees the Mayor could sit on as an ex-officio member.

The Mayor's belief that he could participate was reasonable and consistent with the practices of other local mayors.

The Integrity Commissioner concluded there was no violation of the Code of Conduct and recommended no sanctions.

The Applicant was injured in a motor vehicle accident and received attendant care and housekeeping benefits for 104 weeks.

The Insurer then issued a refusal to pay further benefits, citing the 104-week limit.

Over eight years later, the Applicant disputed the refusal, arguing that the limitation period did not apply because he was later deemed catastrophically impaired, which would entitle him to post-104 week benefits.

The Arbitrator held that the Insurer's refusal was clear and unequivocal, and the Applicant missed the two-year limitation period to dispute it.

The Applicant is therefore precluded from proceeding to arbitration regarding his entitlement to these benefits.

The Applicant sought payment for two treatment plans (OCF-18s) proposing neuropsychometric testing and a mental health assessment, following a motor vehicle accident.

The Insurer had already approved a neuropsychological assessment but denied the other two, arguing they were duplicative and an attempt to circumvent the $2,000 statutory cap per assessment under s. 25(5) of the Schedule.

The Arbitrator found that the Applicant failed to prove the disputed assessments were reasonable and necessary, noting that the requested funding for the neuropsychometric testing exceeded the maximum hourly rate for the time spent, and the mental health assessment was duplicative of previous assessments.

The preliminary issue was resolved in favour of the Insurer.