Robert Bujold

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits from Unifund Assurance Company based on a fraudulent pink insurance slip provided by the owner of the vehicle he was driving.

Unifund refused to respond, arguing there was no nexus between it and the applicant.

The arbitrator held that the applicant's choice of insurer was not arbitrary or random, as he relied on the police report which listed Unifund based on the fraudulent slip.

Therefore, a sufficient nexus existed, and Unifund was the first insurer required to pay benefits pending any priority dispute.

The applicant was struck by a vehicle while walking across an intersection and sustained physical and psychological injuries.

The insurer terminated her income replacement benefits based on an orthopaedic assessment.

The applicant sought arbitration, arguing she suffered from chronic pain with a significant psychological component that prevented her from working.

The arbitrator found that the applicant was completely unable to engage in any employment for which she was reasonably suited, preferring the evidence of her psychological experts over the insurer's assessors.

The arbitrator also granted a special award, finding that the insurer unreasonably withheld benefits by misfiling and ignoring a key psychological report that supported her claim.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until they were terminated by the insurer.

More than two years after the termination, the applicant sought reinstatement of IRBs, arguing that her condition had deteriorated.

The insurer denied the request on the basis that the claim was statute-barred.

The arbitrator held that the applicant could not avoid the limitation period by submitting a new request for IRBs based on a subsequent deterioration in her condition.

The claim was found to be statute-barred under section 281.1 of the Insurance Act and section 51 of the Schedule.

The applicant, a resident of Texas, was injured in a hit-and-run motor vehicle accident while visiting Ontario.

He applied for statutory accident benefits from the Motor Vehicle Accident Claims Fund.

The Fund refused payment on the basis that the applicant was precluded from proceeding under subsections 25(1) and (2) of the Motor Vehicle Accident Claims Act, as Texas does not have a substantially similar fund.

The arbitrator found that the applicant was ordinarily resident in Texas and that Texas does not have a similar fund.

The application for arbitration was dismissed.

Following a finding that the insurer unreasonably withheld income replacement benefits, the arbitrator determined the quantum of the special award.

The arbitrator calculated the maximum permissible special award under section 282(10) of the Insurance Act to be $754,139.36, rejecting the insurer's argument that interest should only run from the date the withholding became unreasonable.

Applying the Persofsky framework, the arbitrator weighed the insurer's conduct, the length of delay, and awards in similar cases, ultimately ordering a lump sum special award of $40,000.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to caregiver, housekeeping, and medical benefits.

The insurer denied the claims on the basis that the applicant's impairments were not caused by the accident.

The arbitrator found that the applicant failed to disclose pre-existing neck and shoulder complaints to his treating practitioners and assessors, and did not report the accident to his family doctor for several months.

The arbitrator concluded that the applicant's impairments were likely caused by pre-existing pathology and the physical strain of caring for his ailing wife, rather than the accident.

The claims were dismissed, save for a small outstanding balance on a previously approved treatment plan.

The Applicant applied for arbitration regarding statutory accident benefits following a motor vehicle accident.

Over a period of two and a half years, the Applicant failed to meaningfully participate in the process, missing multiple pre-hearing discussions and ultimately hanging up on the Arbitrator during a rescheduled telephone conference.

The Arbitrator found the Applicant's conduct to be high-handed, contemptuous of the arbitration process, and indicative of an abandonment of the application.

The application was dismissed as vexatious pursuant to Rule 68 of the Dispute Resolution Practice Code.

No costs were awarded.

The applicant sought production of the insurer's adjuster log notes beyond the date of the first Application for Mediation.

The insurer argued that notes created after the first mediation application were protected by litigation privilege and irrelevant.

The Arbitrator ordered production of the log notes up to the date of the last Application for Mediation, finding that the notes were potentially relevant to the applicant's claim for a special award and that the insurer failed to establish litigation privilege over notes relating to issues that were not yet the subject of a mediation application.

The applicant was injured in a motor vehicle accident and applied for arbitration regarding his entitlement to income replacement and medical benefits.

The parties settled the substantive issues prior to the hearing for a lump sum of $5,000, but could not agree on the quantum of expenses payable to the applicant.

The arbitrator assessed the applicant's expenses, allowing his legal fees in full as reasonable, but reducing several claims for disbursements, including medical reports and photocopies, on the basis that they were partially incurred for the applicant's concurrent tort action or were excessive.

The insurer was ordered to pay $8,110.57 in total expenses.

The applicant was injured in a motor vehicle accident as a pedestrian and claimed statutory accident benefits.

The sole issue in dispute was the quantum of attendant care benefits for the period of June to September 2005.

The applicant sought $1,777.56 per month based on an initial assessment, while the insurer relied on subsequent assessments indicating independence in self-care.

The arbitrator found the applicant's evidence regarding specific attendant care needs during the disputed period to be vague and insufficient to support the full amount claimed.

However, relying on an occupational therapy assessment, the arbitrator determined the applicant required assistance with bathing due to shower door limitations and awarded $168.92 per month for the disputed period.

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

After failing to attend two scheduled pre-hearing discussions and failing to maintain current contact information with the Commission, the insurer brought a motion to dismiss the arbitration proceeding.

The arbitrator found that the insured had effectively abandoned his application and that his conduct rendered the proceeding vexatious.

The application for arbitration was dismissed pursuant to Rule 68.1 of the Dispute Resolution Practice Code, and the insured was ordered to pay $1,000 in expenses to the insurer.

The insurer requested costs for a pre-hearing discussion, arguing the applicant failed to provide necessary information and documentation to engage in meaningful settlement discussions.

The arbitrator found that the applicant's failure to explain her position on the quantum of her income replacement benefit thwarted reasonable attempts to resolve the issues.

The arbitrator awarded the insurer $200.00 in expenses payable forthwith, noting that the applicant's conduct obstructed the pre-hearing proceeding.

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

After their counsel was removed from the record, the applicants failed to attend the scheduled arbitration hearing or provide a forwarding address.

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

As the applicants presented no evidence to support their claims, their applications for medical benefits and housekeeping expenses were dismissed.

The applicants were ordered to pay the insurer's expenses fixed at $750 each.

The applicant was injured when she slipped and fell on ice after exiting a taxi cab.

She applied for statutory accident benefits, which the insurer denied on the basis that the fall was not an 'accident' under section 2(1) of the Statutory Accident Benefits Schedule.

The arbitrator found that the location and orientation of the taxi compelled the applicant to walk around it, leading her to the ice.

The arbitrator concluded that the use or operation of the taxi was a direct cause of the impairment, satisfying the definition of an accident.