Robert Bujold

The applicant sought to vary or revoke a previous arbitration decision that denied her claim for catastrophic impairment and post-104 week benefits.

She argued that post-hearing hospitalizations for psychosis and depression constituted a material change in circumstances and new evidence.

The arbitrator dismissed the application, finding that the new evidence did not disturb the original findings that the applicant's presentation involved a significant degree of malingering or factitious disorder, and she failed to prove her impairments met the catastrophic threshold.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, housekeeping, and attendant care benefits.

The insurer terminated these benefits based on insurer examinations.

The arbitrator found that the applicant remained substantially unable to perform the essential tasks of his pre-accident employment, noting the insurer failed to properly adjust the file when advised the applicant had not returned to work.

The arbitrator awarded income replacement benefits, partial housekeeping and attendant care benefits, and a $5,000 special award against the insurer for unreasonably withholding benefits.

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

After his representatives withdrew due to a breakdown in the solicitor-client relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

As the applicant did not attend to present evidence, he failed to establish his entitlement to the benefits claimed.

The arbitrator dismissed the claims and ordered the applicant to pay the insurer's expenses of the arbitration.

The insurer was entirely successful in an arbitration regarding the applicant's claim for weekly caregiver benefits.

The insurer sought its expenses of the arbitration proceeding under the Expense Regulation.

The arbitrator found that the insurer's complete success entitled it to its reasonable expenses.

Applying a 2:1 ratio for preparation to hearing time and allowing for one counsel, the arbitrator awarded the insurer $5,600.00 for fees and $1,350.00 for disbursements, for a total of $6,950.00 inclusive of HST.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After her legal representative withdrew due to a breakdown in the solicitor-client relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

As the applicant did not attend to present evidence, she failed to establish entitlement to the benefits claimed.

The arbitrator dismissed the claims and ordered the applicant to pay the insurer's arbitration expenses in the amount of $1,100.

The applicants claimed statutory accident benefits following a reported hit-and-run motor vehicle collision.

The insurer denied the claims, arguing the applicants were not involved in an 'accident' as defined in the Schedule and putting them to strict proof that the collision occurred as reported.

Following a preliminary issue hearing, the arbitrator found the applicants' evidence credible and corroborated by circumstantial evidence, while finding the insurer's accident reconstruction evidence unpersuasive.

The arbitrator concluded that the applicants were involved in an accidental collision and were therefore involved in an 'accident' under subsection 2(1) of the Schedule.

The applicant claimed statutory accident benefits following a motor vehicle accident but failed to attend the arbitration hearing.

Her representative was permitted to withdraw due to a breakdown in the representative-client relationship.

As the applicant did not attend to present evidence, her claims were dismissed and she was ordered to pay $500 toward the insurer's expenses.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After the applicant's representatives were permitted to withdraw due to a breakdown in the solicitor-client relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

The arbitrator proceeded in the applicant's absence.

As the applicant presented no evidence to establish entitlement to the claimed benefits, the claims were dismissed.

The Applicants claimed statutory accident benefits following a motor vehicle accident.

At the arbitration hearing, the Applicants failed to attend.

Their representative requested and was permitted to withdraw due to a breakdown in the representative-client relationship.

As the Applicants presented no evidence to establish their entitlement to the benefits claimed, their claims were dismissed.

The Applicants were ordered to pay $1,500 each toward the Insurer's arbitration expenses.

The applicant was injured in a motor vehicle accident and applied for weekly caregiver benefits, claiming he was the primary caregiver for his two young children.

The insurer denied the claim.

At arbitration, the evidence showed that while the applicant was an involved father, he worked full-time in a limousine business, whereas his wife was a full-time homemaker who handled the majority of day-to-day childcare tasks.

The arbitrator concluded that the applicant's wife, not the applicant, was the primary caregiver at the time of the accident.

As caregiver benefits are only available to the primary caregiver, the application was dismissed.

The applicants claimed statutory accident benefits following a motor vehicle accident.

After their legal representative withdrew due to a breakdown in the relationship, the applicants failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

The arbitrator proceeded in their absence and dismissed their claims for failing to present evidence to establish entitlement.

Each applicant was ordered to pay $500 toward the insurer's arbitration expenses.

The insurer sought repayment of statutory accident benefits paid to four applicants, alleging the motor vehicle accident was staged.

The applicants failed to attend the hearing.

Relying on uncontroverted accident reconstruction evidence, the arbitrator found the accident did not occur as reported and that the applicants received benefits as a result of wilful misrepresentation.

However, interpreting section 47(1)(a) of the Schedule strictly, the arbitrator held the insurer could only recover benefits paid directly to the insured persons, not those paid to third-party service providers.

Three applicants were ordered to repay the amounts paid directly to them, and all four were ordered to pay the insurer's arbitration expenses.

The applicant claimed statutory accident benefits following an alleged motor vehicle accident.

The insurer disputed that an accident took place.

The applicant's representative withdrew after losing contact with her for over three years.

The applicant failed to attend the preliminary issue hearing despite being served with notice.

As the applicant did not present any evidence to establish that an accident occurred, her claims for accident benefits were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs), transportation expenses, and the cost of a medical assessment.

The insurer denied the benefits, arguing the applicant had returned to work and did not meet the disability tests.

The arbitrator found the applicant suffered a substantial inability to perform her pre-accident employment for the first 104 weeks and a complete inability to engage in suitable employment thereafter until she commenced a new career.

The arbitrator awarded the IRBs, transportation expenses, and assessment costs.

Furthermore, the arbitrator ordered the insurer to pay a $10,000 special award because it unreasonably withheld IRBs by failing to have its accountant review updated financial information that would have revealed flaws in its initial denial.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After his legal representative withdrew due to a breakdown in the relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

The arbitrator proceeded in the applicant's absence pursuant to Rule 37.7 of the Dispute Resolution Practice Code.

As the applicant presented no evidence to establish entitlement to the claimed benefits, the application was dismissed and the applicant was ordered to pay the insurer's expenses of $1,500.

The applicants sought statutory accident benefits following a reported motor vehicle collision.

The insurer terminated benefits and sought repayment, alleging the collision did not occur as reported.

At a preliminary issue hearing, the arbitrator weighed competing accident reconstruction expert evidence and the applicants' testimony.

Finding the applicants' evidence credible and the applicant's expert persuasive, the arbitrator concluded on a balance of probabilities that the applicants were involved in an 'accident' as defined in section 2(1) of the Schedule.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After his legal representative withdrew due to a breakdown in the relationship, the applicant failed to attend pre-hearing discussions and the scheduled arbitration hearing.

The arbitrator proceeded in the applicant's absence and dismissed the application for arbitration, awarding $1,500 in expenses to the insurer.

The applicant sought caregiver and housekeeping benefits following a motor vehicle accident.

The insurer denied the claims, arguing the applicant was permanently disentitled for failing to submit a Disability Certificate (OCF-3) in a timely manner.

The Arbitrator held that the applicant was disentitled to housekeeping benefits because she never submitted an OCF-3 for that claim.

However, the insurer could not rely on the late submission of the caregiver OCF-3 to deny benefits because it failed to clearly communicate the consequence of permanent disentitlement to the applicant.

On the merits, the Arbitrator dismissed the caregiver claim, finding the applicant's evidence regarding her pre-accident caregiving responsibilities and post-accident needs to be inconsistent and unreliable.

The applicant applied for statutory accident benefits following an alleged motor vehicle accident, which the insurer denied on the basis that the accident was staged.

The applicant's representative brought a motion to withdraw due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the arbitration hearing despite being properly served.

The arbitrator granted the representative's motion to withdraw and proceeded with the hearing in the applicant's absence.

As the applicant presented no evidence, the application for arbitration was dismissed, and the applicant was ordered to pay the insurer's expenses of $948.31.

The applicant applied for statutory accident benefits following an alleged motor vehicle accident, which the insurer denied on the basis that the accident was staged.

The applicant's representative brought a motion to withdraw due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the arbitration hearing.

The arbitrator granted the representative's motion to withdraw, dismissed the application for arbitration due to the applicant's failure to attend and present evidence, and ordered the applicant to pay the insurer's arbitration expenses.