Nancy Makepeace

The applicant was injured in a motor vehicle accident and received weekly income benefits until they were terminated by the insurer in July 1991.

The applicant applied for arbitration in December 1993, more than two years after the termination of benefits.

The insurer raised a preliminary issue that the application was barred by the two-year limitation period under subsection 281(5) of the Insurance Act.

The arbitrator found that the applicant failed to adequately explain the delay and held that he was not entitled to proceed to arbitration.

The applicant was awarded his expenses for the preliminary hearing, and the insurer's request for expenses was denied.

A treatment provider commenced an arbitration proceeding against an insurer in the name of the insured person, seeking payment of $260 for case management services.

The treatment provider relied on an authorization signed by the insured person.

The arbitrator held that under section 281(1) of the Insurance Act, only the insured person has the statutory right to commence an arbitration, and this right cannot be assigned to a treatment provider.

In the alternative, the arbitrator found that the case management services, which primarily involved attempts to secure benefits, were not rehabilitation services required as a result of the accident.

The application was dismissed and no expenses were awarded.

The applicant was injured in a motor vehicle accident and received weekly accident benefits until the insurer terminated them, arguing she was capable of returning to work.

The applicant applied for arbitration, claiming ongoing disability from her two pre-accident jobs as a housekeeping aid and a chiropractic assistant.

The arbitrator found that while the applicant could likely perform the chiropractic assistant role, she remained substantially disabled from the physical demands of the housekeeping job due to accident-related lower back pain.

The arbitrator ordered the reinstatement of weekly benefits, along with interest on overdue payments.

Additionally, the arbitrator granted a $2,000 special award against the insurer for unreasonably delaying initial benefit payments without providing required notice, and awarded the applicant her arbitration expenses.

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits for university residence fees, arguing her injuries prevented her from commuting from home as originally planned.

The insurer paid for the first two years but disputed entitlement for subsequent years, alternatively arguing for a deduction of hypothetical commuting and meal costs.

The arbitrator found that the applicant's physical and psychological injuries, including whiplash and post-traumatic stress disorder, rendered her unable to commute daily.

The residence fees were deemed a reasonable rehabilitation expense under section 6 of the Statutory Accident Benefits Schedule.

The arbitrator also rejected the insurer's request to deduct hypothetical commuting costs, finding them speculative.

The applicant, a taxi driver, was injured in a motor vehicle accident while driving a cab owned by another individual and insured by Canadian General.

She also owned a personal vehicle insured by Pilot.

Canadian General argued that she was not a named insured under its policy and must claim benefits from Pilot.

The arbitrator found that the cab was made available for the applicant's regular use and rented to her, bringing her within subsection 3(1) of the No-Fault Benefits Schedule.

This provision gave her the same rights as a named insured, allowing her to elect to claim benefits from Canadian General under subsection 268(5) of the Insurance Act.

Canadian General was held liable to pay the benefits.

The applicant was injured in a motor vehicle accident and applied for weekly and childcare benefits under the No-Fault Benefits Schedule.

The insurer denied the benefits, arguing that the applicant's disability resulted from a previous workplace injury.

The arbitrator found the applicant lacked credibility due to inconsistencies between his testimony and prior statements regarding his pre-accident activities.

Relying on medical reports indicating that the applicant's post-accident condition was substantially the same as his pre-accident condition and that his disability was largely psychogenic, the arbitrator concluded the applicant failed to prove he was substantially unable to perform his essential tasks as a result of the accident.

The claims for weekly and childcare benefits were dismissed, but the applicant was awarded his arbitration expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits until August 1991, when he returned to work part-time at a bakery.

He sought ongoing weekly income benefits, arguing he remained substantially unable to perform his pre-accident job as a furniture delivery driver.

The arbitrator found that the applicant failed to prove substantial inability after August 1991, noting his return to work, medical evidence of improvement, and failure to report his return to work to the insurer.

The arbitrator also determined the correct quantum of pre-accident earnings, ordered repayment of overpaid benefits, and dismissed the claim for a special award.

The applicant, a homemaker, claimed she was totally disabled from performing her essential tasks after being injured as a passenger on a bus.

She applied for weekly benefits, childcare benefits, and a special award under the No-Fault Benefits Schedule.

The arbitrator dismissed the claims for benefits, finding the applicant's evidence of total disability implausible and inconsistent with medical reports, her own conduct, and observations by the insurer's representatives.

The arbitrator concluded the applicant was not substantially unable to perform her essential tasks.

However, the applicant was awarded her arbitration expenses as the proceeding was not brought for an improper purpose.

The applicant was injured in a motor vehicle accident and applied for accident benefits.

The insurer terminated weekly income benefits, and the parties attended mediation.

The insurer argued the dispute was resolved at mediation, relying on a signed Memorandum of Agreement and Report of Mediator.

The applicant contended she did not agree to the terms and signed under pressure.

The arbitrator found that the applicant understood the terms of the settlement and that signing the Memorandum would resolve the dispute.

The arbitrator concluded there was no undue influence or vitiating factor, and held that the mediation was successful in resolving the dispute, precluding the applicant from proceeding to arbitration.

The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer.

The insurer sought to exclude the applicant from receiving benefits under clauses 17(1)(c) and (d) of the No-Fault Benefits Schedule, arguing he was driving without insurance.

The arbitrator found that clause 17(1)(c) requires a conviction for driving without insurance, which the applicant did not have, as his charge was withdrawn and he pleaded guilty only to failing to have an insurance card.

The arbitrator also held that clause 17(1)(d) relates to licensing matters, not compulsory insurance legislation.

The applicant was found not to be excluded from receiving benefits and was awarded his expenses for the preliminary issue hearing.

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

The arbitrator held that the applicant's pre-accident income included cash payments and food (beef and milk) received from his father in exchange for his work on the family farm, as these constituted 'income' under subsection 12(7) of the No-Fault Benefits Schedule.

However, the arbitrator dismissed the applicant's claim for reimbursement of the cost of hiring farm workers to replace his labour, finding that these were business expenses rather than rehabilitation expenses under clause 6(1)(f).

The applicant was awarded interest on overdue benefits and his expenses for the arbitration.

The applicant was injured in a motor vehicle accident and received physiotherapy treatments.

His employment insurer paid 80% of the cost, and the no-fault insurer paid the remaining 20%.

The applicant sought full reimbursement from the no-fault insurer, arguing that the employment benefits were not 'reasonably available' because they reduced his lifetime maximum coverage.

The arbitrator dismissed the claim, finding that the employment benefits were reasonably available and that the no-fault insurer is a secondary insurer under the No-Fault Benefits Schedule.

The applicant was awarded his arbitration expenses for bringing an arguable case on a novel issue.

The Applicant was injured in a motor vehicle accident and sought weekly income benefits under the No-Fault Benefits Schedule, claiming he had an offer of employment made prior to the accident.

The Insurer disputed the existence of the pre-accident offer and paid benefits based on his pre-accident employment.

The arbitrator found the Applicant's evidence regarding the timing of the job offer implausible and uncorroborated.

The arbitrator concluded that the Applicant failed to prove on a balance of probabilities that the offer of employment was made before the accident.

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits for a Kenko Sleep System (a magnetic mattress and pillow) costing $1,607.70.

The insurer denied the claim, arguing the device was experimental and not a medical device.

The arbitrator found that while the system qualified as a medical device under the Schedule, the applicant failed to prove it was a reasonable and necessary treatment for her accident-related impairment.

The medical evidence did not support the therapeutic value of the device for her soft tissue injuries.

The application for arbitration was dismissed, and no expenses were awarded.