M. Patricia Richardson

The appellant appealed an arbitrator's decision denying reimbursement for $200 in legal fees incurred to complete an application for no-fault accident benefits.

The Director's Delegate upheld the arbitrator's finding that legal fees do not qualify as 'other goods and services' under section 6(1)(f) of the No-Fault Benefits Schedule.

The Delegate agreed that the Schedule requires such expenses to be of a nature that a medical practitioner could validly opine on their necessity, which does not apply to legal fees.

The appeal was dismissed.

The Appellant, an injured worker entitled to workers' compensation benefits, appealed an Arbitrator's decision denying him no-fault benefits under section 21 of the No-Fault Benefits Schedule.

The Appellant argued that the plain wording of section 21 entitled him to benefits either because he commenced a tort action or because he was not receiving workers' compensation payments.

The Director's Delegate upheld the Arbitrator's interpretation that section 21 requires a bona fide action for threshold-type injuries, and found the Arbitrator had jurisdiction to determine the action was not bona fide as it was commenced solely to qualify for no-fault benefits.

The appeal was dismissed, but the Appellant was awarded expenses due to the novelty and importance of the legal issues.