Marshall Schnapp

The applicant was injured while repairing a vehicle and applied for statutory accident benefits from Unifund, his personal auto insurer.

Unifund denied the claim, relying on the 'garage worker' exclusion, and did not initiate a priority dispute against Intact, the applicant's commercial liability insurer.

The arbitrator held that FSCO does not have jurisdiction to determine coverage exclusions in this context, as such issues must be resolved through a private priority dispute arbitration under O. Reg. 283/95.

Unifund, as the first insurer to receive the application, was ordered to respond to and adjust the claim.

The application against Intact was not dismissed to prevent further prejudice to the applicant.

The applicant, a long-haul truck driver, was injured in a motor vehicle accident in North Carolina.

He elected to opt out of the WSIB scheme to pursue a tort action and subsequently applied for statutory accident benefits.

The insurer argued that the applicant's tort claim was barred under North Carolina law due to contributory negligence, and that his election out of WSIB was made primarily to claim accident benefits, which would bar his claim under section 61 of the Schedule.

The arbitrator found the applicant credible and concluded that, at the time of the election, his primary purpose was to pursue a tort action to recover his losses.

Therefore, the election was valid and the claim for accident benefits was not barred.

The parties reached a settlement regarding accident benefits, but the responding party failed to execute the settlement documents for over a year.

The moving party brought a motion to dismiss the application for arbitration and sought costs.

The responding party consented to the dismissal but opposed costs, citing a period of incarceration.

The arbitrator dismissed the application on consent and ordered the responding party to pay $750 in expenses to the moving party for the unnecessary delay and additional proceedings.

The Insurer sought its expenses following an arbitration hearing where the Applicant's claims for statutory accident benefits were either withdrawn or dismissed.

The Applicant argued that the Insurer's conduct prolonged the proceeding and that the claimed costs were excessive.

The Arbitrator found that the Insurer was entirely successful and entitled to expenses.

Applying a 3:1 ratio for preparation to hearing time and reducing excessive disbursements, the Arbitrator fixed the Insurer's expenses at $12,070.91 and ordered the Applicant to pay this amount.

Following an arbitration where the applicant's claims for statutory accident benefits were denied, the insurer sought its expenses.

The arbitrator found that the insurer was entirely successful and entitled to its expenses.

Applying a 2:1 ratio for preparation to hearing time for a three-day hearing, the arbitrator fixed the insurer's expenses at $10,847.70, inclusive of fees, disbursements, and taxes, and ordered the applicant to pay this amount.

The Insurer requested an expense hearing following an arbitration decision where the Applicant was only marginally successful, recovering $7,119.94 out of claims potentially worth millions.

The Arbitrator found that the Insurer was predominantly successful and that the Applicant's conduct, including multiple interim benefit motions and failures to produce documents, prolonged and hindered the proceedings.

Applying a 3:1 ratio for preparation to hearing time, the Arbitrator ordered the Applicant to pay the Insurer's expenses fixed at $18,892.61, inclusive of fees, disbursements, and taxes.

The insurer raised a preliminary issue seeking to stay the arbitration pending the applicant's attendance at an updated occupational therapy in-home assessment and a psychological examination under section 44 of the Statutory Accident Benefits Schedule.

The applicant argued the occupational therapy assessment was causing him severe physical and psychological distress.

The arbitrator ordered the arbitration stayed until the applicant completes the psychological assessment and the remaining functional testing for the occupational therapy assessment, though the latter could be conducted by a different occupational therapist.

The arbitrator also ruled that the applicant's service provider was not required to speak with the insurer's assessor or provide further documentation under section 46.2, as sufficient information had already been provided.

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

After the applicant failed to attend a pre-hearing discussion and his representative lost contact with him, the insurer brought a motion to dismiss the application for arbitration.

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 $750 in expenses for preparing for and attending the proceedings.

The applicant was injured in a motor vehicle accident and sought medical benefits and the cost of an MRI examination from her insurer.

The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

At the arbitration hearing, the arbitrator excluded the applicant's arbitration brief due to late service but allowed her to testify.

The arbitrator found that the applicant failed to provide compelling evidence of a pre-existing condition that would exempt her from the MIG.

Relying on the insurer's medical reports, the arbitrator concluded the injuries were minor.

The claims for medical benefits and the MRI cost were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to attend multiple pre-hearing discussions and the preliminary issue hearing.

The arbitrator dismissed the application for arbitration due to the applicant's failure to appear and present evidence.

The insurer was awarded $750.00 in expenses for preparing for and participating in the proceedings.

The applicants claimed accident benefits following a motor vehicle collision.

The insurer denied the claims on the basis that the collision arose from the applicants' intentional and wilful acts.

The applicants failed to attend a scheduled pre-hearing and did not file any submissions in response to the insurer's motion to dismiss.

The arbitrator found that the applicants failed to meet their onus of proof and abandoned their claims.

The applications for arbitration were dismissed, and each applicant was ordered to pay $4,181.34 in expenses to the insurer.

The applicant failed to attend multiple pre-hearing discussions regarding his claim for statutory accident benefits.

His legal representative brought a motion to withdraw from the record due to a breakdown in the relationship, which was granted.

The insurer brought a motion to dismiss the application for arbitration due to the applicant's failure to participate.

The arbitrator dismissed the application and awarded the insurer $1,500 in expenses.

The applicant's legal representatives brought a motion to withdraw from the proceeding due to a breakdown in the relationship.

The applicant failed to attend two scheduled pre-hearings despite being notified that her attendance was mandatory and that failure to attend would result in a motion to dismiss her application.

The arbitrator granted the motion to withdraw, dismissed the application for arbitration due to the applicant's failure to participate, and awarded the insurer $500 in expenses.