Robert Kominar

The applicant was injured in a motor vehicle accident and sought housekeeping and caregiving benefits from her insurer.

She moved to California shortly after the accident and gave inconsistent medical histories to various health care providers, attributing her injuries to a yoga incident or moving boxes rather than the car accident.

The arbitrator found the applicant lacked credibility and failed to prove on a balance of probabilities that she suffered any disability related to caregiving or housekeeping as a result of the motor vehicle accident.

The claims were dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for various medical treatments, including physiotherapy, acupuncture, and a YMCA membership.

The insurer denied the treatment plans based on independent medical examinations.

At arbitration, the arbitrator found that the insurer and its assessors failed to consider the applicant's physically demanding summer employment, treating him merely as a sedentary student.

The arbitrator rejected the insurer's expert reports as lacking sufficient reasoning and preferred the evidence of the applicant's treating practitioners.

The arbitrator concluded that the disputed treatment plans were reasonable and necessary, ordering the insurer to pay the claimed amounts, interest, and the applicant's arbitration expenses.

The insurer brought a motion to stay the arbitration proceedings and prohibit the insured from receiving income replacement benefits until he attended independent medical examinations (neurology, physiatry, and psychology).

The arbitrator dismissed the motion, finding that the requested examinations were not reasonably necessary at this stage to adjust the claim, but rather appeared to be sought for the tactical purpose of marshalling evidence for the upcoming arbitration.

The insurer had prior notice of the insured's neurological concerns but failed to follow up in a timely manner.

The insured person was fatally injured in a motor vehicle accident.

Her estate applied for statutory accident benefits, including caregiver benefits, arguing that death constitutes an 'impairment' under the Statutory Accident Benefits Schedule.

The insurer denied the claim, arguing that death is distinct from impairment and that post-mortem benefits are limited to death and funeral benefits.

The arbitrator held that death is not an impairment for the purpose of qualifying for caregiver benefits, as interpreting it as such would create absurdities and contradict the clear distinction between death and impairment in the Insurance Act.

The applicant was injured in a motor vehicle accident while driving a truck weighing over 11,000 kilograms.

At the time, he held only a G2 class driver's licence, which authorized him to drive vehicles up to 11,000 kilograms.

The insurer denied income replacement benefits under s. 30(1)(b) of the Statutory Accident Benefits Schedule, arguing the applicant was driving without a valid driver's licence for that specific vehicle.

The arbitrator agreed, finding that driving beyond the scope of one's licence constitutes driving without a valid driver's licence, thereby excluding the applicant from receiving income replacement benefits.