Marvin J. Huberman

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment under the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant sustained a catastrophic impairment under both the 55% whole person impairment (WPI) threshold (clause 2(1.2)(f)) and the marked impairment threshold for mental or behavioural disorders (clause 2(1.2)(g)).

The arbitrator accepted the applicant's physical impairment rating of 48% WPI and assessed her mental and behavioural impairment at 33% WPI, resulting in a combined 65% WPI.

The arbitrator also found a marked impairment in three of four functional spheres.

Regarding the claimed expenses totaling $83,417.90, the arbitrator awarded only $1,925.00 for a mental health assessment, dismissing the remainder because they were not properly submitted through the HCAI system as required by the Schedule.

Following an arbitration decision awarding the applicant attendant care and housekeeping benefits, the parties disputed the entitlement to and quantum of expenses.

The arbitrator found the applicant achieved a sufficient degree of success to warrant an award of expenses.

The applicant's request for full indemnity costs on a solicitor/client scale or a special award was rejected, as the arbitrator's discretion is constrained by the Insurance Act and the Dispute Resolution Practice Code.

The arbitrator awarded the applicant $67,688.74 in expenses, applying an enhanced hourly rate of $150.00.

The applicant's claim for interest on overdue payments was dismissed, as the insurer was not required to pay until 10 business days after receiving a Form 1 assessment.