Paulina Gueller

The applicant sought accident benefits following a motor vehicle accident where a garage door closed on his car.

The insurer denied the treatment plans, arguing the applicant's injuries fell under the Minor Injury Guideline (MIG) and were related to pre-existing conditions.

The arbitrator found no compelling evidence that the applicant suffered an impairment directly related to the accident or that his pre-existing chronic pain was exacerbated by it.

The application for medical benefits, cost of examinations, and interest was dismissed.

Following an arbitration where the insurer successfully defended against the applicant's claims for statutory accident benefits, the insurer requested an expense hearing.

The insurer sought $20,630.09 in costs.

The arbitrator found the insurer's claimed hours unsubstantiated for a non-complex case and noted the applicant's case had some merit, as evidenced by the insurer's settlement offers.

Applying a global approach based on Legal Aid rates, the arbitrator ordered the applicant to pay the insurer $8,595.96 in expenses.

The applicant sought a non-earner benefit following a 2013 motor vehicle accident, claiming it exacerbated her pre-existing psychiatric issues and chronic pain.

The insurer denied the benefit, arguing her activities of daily living had not substantially changed.

The arbitrator found that the applicant's normal life had changed due to a prior 2011 accident and family conflicts, not the 2013 accident.

Despite an aggravation of her chronic pain, she continued to engage in substantially all her pre-accident activities, such as attending workshops, driving, and socializing.

The application was dismissed, and expenses were awarded to the insurer.

The applicant sought accident benefits following a motor vehicle accident and applied for arbitration.

The applicant failed to attend the scheduled arbitration hearing.

The insurer brought a motion to dismiss the application.

The arbitrator proceeded in the applicant's absence pursuant to Rule 37.9 of the Dispute Resolution Practice Code.

As the applicant bore the onus of proving entitlement and presented no evidence, the application was dismissed.

The arbitrator awarded $1,000 in expenses to the insurer due to the applicant's failure to prove his claim and attend the hearing.

The Applicant sought to withdraw his Application for Arbitration for accident benefits.

The Insurer consented to the withdrawal but sought its expenses of $6,166.85.

The Arbitrator permitted the withdrawal and ordered the Applicant to pay the Insurer's expenses fixed at $1,500, noting the Applicant's participation in the process and the lack of evidence that the application was vexatious or in bad faith.

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

The insurer denied several benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the applicant had developed chronic pain syndrome and psychological impairments, removing his injuries from the MIG.

The arbitrator awarded medical benefits for physiotherapy and transportation expenses.

The applicant was also awarded income replacement benefits for the pre-104-week period, as he suffered a substantial inability to perform his pre-accident job.

However, the claim for post-104-week income replacement benefits was dismissed, as the applicant failed to prove a complete inability to engage in any suitable employment.

The claim for a special award was also dismissed, as the insurer had not unreasonably withheld payments.

The applicant was injured in a motor vehicle accident when she was 13 years old.

She applied for non-earner benefits upon turning 16, but the insurer failed to commence payments or schedule insurer examinations until 20 months later.

When the insurer finally scheduled the examinations, the applicant refused to attend, citing the unilateral scheduling and misleading notices.

The arbitrator found that the insurer's notices were inaccurate and failed to comply with the Schedule, and that the applicant provided a reasonable explanation for non-attendance.

The insurer was ordered to pay the withheld non-earner benefits with interest.

However, the applicant's claim for a special award was dismissed as both parties contributed to the delay.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs).

At the time of the accident, the applicant was receiving Long Term Disability (LTD) benefits.

The parties disputed how the LTD benefits should be deducted from the IRB quantum under the Statutory Accident Benefits Schedule.

The applicant argued for a net deduction, while the insurer argued for a gross deduction.

The arbitrator determined that, based on the language of the Schedule and the treatment of LTD benefits as gross employment income, the insurer may deduct 70% of the gross income received for LTD benefits when calculating the weekly IRB quantum.

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

After reaching a settlement at a pre-hearing, the applicant failed to execute the settlement documents and stopped instructing his counsel, who was subsequently removed from the record.

The insurer brought a motion to dismiss the claim.

The applicant did not respond to the motion or participate further.

The arbitrator found the application abandoned and frivolous, dismissing it under Rule 68.1 of the Dispute Resolution Practice Code.

The insurer was awarded $500 in expenses.

The applicant sought statutory accident benefits following a 2014 motor vehicle accident, claiming entitlement to non-earner benefits, medical benefits for orthotics and physical therapy, and the cost of examinations for a chronic pain assessment and a Functional Abilities Evaluation.

The arbitrator dismissed all claims.

Relying on surveillance evidence and the insurer's expert reports, the arbitrator found the applicant did not suffer a complete inability to carry on a normal life.

The arbitrator also found the applicant's expert testimony inconsistent and unreliable, concluding that the proposed treatment plans and assessments were not proven to be reasonable and necessary.

The applicant failed to attend his scheduled arbitration hearing for statutory accident benefits.

At the commencement of the hearing, the applicant's counsel successfully moved to be removed from the record due to a breakdown in the solicitor-client relationship.

The arbitrator proceeded in the applicant's absence and dismissed the application for arbitration because the applicant failed to meet his burden of proof.

The insurer was awarded expenses for the proceeding, while the applicant was awarded expenses for a previous motion on which he was successful.

The Applicant was injured in a motor vehicle accident and sought non-earner benefits.

The Insurer terminated the benefits and argued the Applicant was statute-barred from proceeding to arbitration because the two-year limitation period had expired.

The Arbitrator found that the Insurer's termination letter was confusing and did not constitute a clear and unequivocal refusal to pay benefits, as it simultaneously requested an election form and provided a right to dispute.

Therefore, the limitation period was not triggered, and the Applicant was not precluded from proceeding to arbitration.

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

The insurer denied several treatment plans and attendant care benefits, and requested the applicant attend insurer's examinations under Section 44 of the Statutory Accident Benefits Schedule.

The applicant failed to attend the scheduled examinations.

The insurer raised a preliminary issue that the applicant was precluded from proceeding to arbitration under Section 55(2) of the Schedule.

The Arbitrator found that the insurer provided sufficient medical reasons for requesting the examinations and that the applicant failed to reasonably justify his non-attendance.

Consequently, the applicant was precluded from arbitrating the disputed benefits.

The applicant sought accident benefits following a motor vehicle accident.

At the scheduled arbitration hearing, the applicant failed to attend despite a peremptory order.

The insurer brought a motion to dismiss the application without costs, noting a settlement had been reached but the settlement disclosure notice was unsigned.

The arbitrator proceeded in the applicant's absence under Rule 37.9 of the Dispute Resolution Practice Code.

Finding no objective evidence of a finalized settlement to apply Rule 69.4, but noting the applicant's failure to attend and lack of intent to continue, the arbitrator dismissed the application without costs.

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

The applicant failed to attend two pre-hearing discussions and the arbitration hearing itself.

The insurer brought a motion to dismiss the application.

The arbitrator proceeded in the applicant's absence pursuant to Rule 37.9 of the Dispute Resolution Practice Code and dismissed the application because the applicant failed to meet his burden of proof.

The insurer was awarded $1,964.35 in expenses due to the applicant's conduct in unnecessarily prolonging the proceeding.

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

At the scheduled arbitration hearing, the Applicant failed to attend.

The Applicant's counsel brought a motion to be removed from the record due to a breakdown in the lawyer-client relationship, which was granted.

The Insurer subsequently moved to dismiss the application.

The Arbitrator proceeded in the Applicant's absence under Rule 37.9 of the Dispute Resolution Practice Code and dismissed the application, as the Applicant failed to present any evidence to prove entitlement to the claimed benefits.

The Insurer was awarded $1,500 in expenses.

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

At the arbitration hearing, the applicant failed to attend.

The applicant's counsel brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, which was granted.

The insurer brought a motion to dismiss the application for arbitration due to the applicant's failure to attend the pre-hearings and the hearing.

The arbitrator proceeded in the applicant's absence and dismissed the application, as no evidence was presented to support the claims.

The insurer was awarded expenses of $2,182.54.

The applicant sought statutory accident benefits following a motor vehicle accident but passed away before the arbitration hearing.

The applicant's representative was unable to obtain instructions from the estate and was removed from the record.

As no one attended the hearing on behalf of the applicant, the application for arbitration was dismissed.

The insurer sought costs personally against the applicant's representative, arguing she contributed to unnecessary delay.

The arbitrator denied the request, finding the representative did not act in bad faith or unreasonably prolong the proceedings.

The arbitrator also declined to award costs against the estate, ordering each party to bear its own expenses.

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

After the applicant's counsel was removed from the record, the applicant failed to attend a pre-hearing discussion and the subsequent arbitration hearing.

The arbitrator proceeded in the applicant's absence and dismissed the application for arbitration because the applicant failed to present evidence to support his claims.

The insurer was awarded $500 in expenses due to the applicant's failure to pursue the claim and attend the proceedings.

The applicant sought accident benefits following a motor vehicle accident but failed to appear at the arbitration hearing or communicate with her former counsel.

The arbitrator proceeded in the applicant's absence and dismissed the application for arbitration because the applicant failed to meet her onus of proving entitlement to the claimed benefits.

The insurer was awarded $875.00 in expenses due to the applicant's failure to pursue her claim and attend the hearing.