Pamila Ahlfeld

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

After mediation failed, the applicant applied for arbitration.

The applicant failed to attend a prehearing discussion and subsequently failed to attend the arbitration hearing.

The applicant's counsel brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, having been unable to contact the applicant.

The arbitrator granted counsel's motion to withdraw.

The insurer requested that the application for arbitration be dismissed.

Finding that the applicant had been properly notified and failed to meet her onus to establish entitlement to the claims, the arbitrator dismissed the application for arbitration.

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

The insurer denied income replacement benefits and housekeeping expenses on the basis that the applicant was driving with a suspended licence at the time of the accident, triggering the exclusion under section 30(1)(b) of the Schedule.

The applicant argued he was unaware of the suspension and raised a due diligence defence, claiming he had given his stepson money to pay his traffic fines.

The arbitrator found the applicant failed to establish due diligence, as he took no steps to verify the fines were paid or to appeal his subsequent conviction.

The arbitrator also determined she lacked jurisdiction to grant relief from forfeiture under the Insurance Act or the Courts of Justice Act.

The applicant was precluded from proceeding to arbitration for the disputed benefits.

The applicant was involved in two serious motor vehicle accidents, the first in December 2010 and the second in June 2011, which rendered him a paraplegic.

He applied for attendant care benefits from the Motor Vehicle Accident Claims Fund for the first accident while receiving benefits from another insurer for the second.

The arbitrator found the applicant was not entitled to benefits for the period between the two accidents because he failed to prove the expenses were incurred and the Fund did not unreasonably withhold payment.

For the period after the second accident, the arbitrator determined the applicant required 24-hour care and was entitled to $9,432.25 per month, subject to deduction of amounts received from the other insurer to prevent double recovery.

Claims for retroactive benefits, hospital stay benefits, interest, and a special award were dismissed.

The applicant was catastrophically injured in a motor vehicle accident and sought attendant care benefits of $6,000 per month while residing in a nursing home.

The insurer argued it was only required to pay the nursing home copay amount plus reasonable and necessary family care services, relying on section 60(2) of the Schedule.

The arbitrator agreed with the insurer, finding that paying the maximum benefit when the actual incurred nursing home costs were lower would amount to unfair enrichment.

The arbitrator calculated the reasonable and necessary family care services to be added to the copay amount.

The applicant's claim for a home renovation assessment was denied because prior approval was not obtained and there was no immediate risk of harm.

Interest was awarded on overdue amounts, but a special award was denied as the insurer had acted reasonably.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which the insurer denied.

The applicant filed for arbitration but subsequently failed to attend multiple prehearings and did not respond to communications.

The insurer brought a motion to dismiss the application.

The arbitrator found that the applicant had abandoned her proceeding and dismissed the application for arbitration under Rule 68 of the Dispute Resolution Practice Code.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which the insurer terminated.

The applicant applied for arbitration but failed to attend the prehearing, and his representative withdrew from the record.

The arbitrator issued a notice of intention to dismiss the arbitration.

The applicant did not respond.

The arbitrator dismissed the application for arbitration and ordered the applicant to pay the insurer's expenses fixed at $1,500.00.

The applicant, who was injured in a motor vehicle accident, applied for arbitration regarding the quantum of his attendant care benefits.

The insurer requested that the applicant attend an occupational therapy examination and a neuropsychological examination pursuant to section 44 of the Statutory Accident Benefits Schedule.

The applicant refused, arguing the insurer had sufficient information and failed to comply with section 42(7) of the Schedule.

The arbitrator found that the requested examinations were reasonably necessary given the time elapsed since the last examinations and the changing nature of the applicant's needs.

The arbitrator also held that the insurer's non-compliance with section 42(7) did not bar the request.

The arbitration was stayed pending the applicant's attendance at the examinations.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, which were denied by the insurer.

The applicant failed to attend the preliminary issue hearing, as well as previous proceedings, and her previous counsel had been removed from the record.

The arbitrator dismissed the application for arbitration due to the applicant's failure to meet her onus to establish entitlement to the claims.

The insurer was awarded its reasonable expenses fixed at $3,150.40.