Shari L. Novick

The applicant was injured in a motor vehicle accident and received weekly income benefits before returning to full-time work as a campus police officer.

She continued to miss occasional days of work due to ongoing symptoms and claimed income benefits for those days, as well as for a three-week period following a physiotherapy program.

The arbitrator found that while the applicant was substantially unable to perform the essential tasks of her employment on the occasional days missed, the deduction of 80 percent of her post-accident income under section 15 of the Schedule reduced the payable benefit to zero.

The arbitrator also found the applicant was not disabled during the three-week period in December 1997 and dismissed the claim for a special award, concluding the insurer had not acted unreasonably.

The applicant was severely injured in a motor vehicle accident and received statutory accident benefits for 156 weeks.

The insurer terminated non-earner and childcare benefits at the three-year mark, arguing she did not meet the stricter post-156 week test of being continuously prevented from engaging in substantially all of her normal activities.

The arbitrator found that the applicant's permanent pelvic malalignment caused constant pain that drastically reduced her ability to engage in her pre-accident focus on outdoor activities and active childcare.

The arbitrator concluded the applicant met the test and ordered the insurer to pay ongoing non-earner and childcare benefits, plus arbitration expenses.

The applicant was injured in a motor vehicle accident and sought supplementary medical benefits, an education disability benefit, loss of earning capacity benefits, and a special award from her insurer.

The insurer denied the claims, arguing that the applicant's temporomandibular joint (TMJ) dysfunction and psychological issues were not caused by the accident.

The arbitrator found that the TMJ symptoms were caused by the accident and ordered the insurer to pay for related treatments, but denied the claim for psychological assessments as they were self-referred and not requested from the insurer beforehand.

The claims for education disability and loss of earning capacity benefits were dismissed because the applicant did not meet the statutory criteria.

The request for a special award was also denied as the insurer's conduct was not unreasonable.

The Applicant sought statutory accident benefits after fracturing his ankle while falling from a fence.

He claimed he was climbing the fence to access the backyard and open a carport door from the inside to assist his father in parking a car.

The Insurer denied the claim, arguing the incident did not meet the definition of an 'accident' under the Schedule.

The arbitrator found the Applicant's evidence regarding the existence of the carport door not credible.

Furthermore, even if the evidence were accepted, the connection between climbing a fence 500 feet away and the use or operation of an automobile was too remote.

The application was dismissed, and the Applicant was ordered to pay the Insurer's expenses.

The applicant sought statutory accident benefits after walking into the open hatch of a parked mobile production studio vehicle.

The insurer denied benefits, arguing the incident was not an 'accident' under the Schedule.

The arbitrator applied the Amos test and found that the vehicle was being used as a mobile production studio, not an automobile, at the time of the incident.

The arbitrator concluded that the injuries did not result from the ordinary and well-known activities to which automobiles are put, and therefore the incident did not constitute an 'accident'.

The application was dismissed, but the applicant was awarded expenses.

The applicant was injured when he fell off his bicycle after driving over a patch of hydraulic fluid on the road.

He applied for statutory accident benefits, which the insurer denied on the basis that the incident was not an 'accident' under the Schedule.

The arbitrator found that the fluid originated from a motor vehicle and that the applicant's injuries were directly caused by the use or operation of an automobile, satisfying the amended definition of 'accident'.

The applicant was entitled to the benefits claimed.

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

After his benefits were terminated, he applied for arbitration but failed to appear at the scheduled hearing.

The arbitrator dismissed the application due to the applicant's failure to prove his case.

The insurer requested reimbursement of the $2,000 assessment fee under subsection 282(11.2) of the Insurance Act, arguing the application was frivolous, vexatious, or an abuse of process.

The arbitrator denied the request, finding that the applicant's failure to appear did not automatically render the application entirely devoid of merit or an abuse of process.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them, claiming she could return to her pre-accident work as a piecework sewing machine operator.

The arbitrator found that the applicant's permanent hand injury prevented her from performing the rapid, repetitive movements required for her job, entitling her to ongoing benefits.

The arbitrator also determined that the applicant was an employee rather than an independent contractor, calculating her benefits based on a weekly salary of $275.

The applicant's claim for a special award was dismissed as the insurer's initial termination was based on reasonable medical evidence.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on a disability assessment.

The applicant sought reinstatement of benefits and payment for supplementary medical expenses related to dental services and nutritional counselling for swallowing difficulties.

The arbitrator found that the applicant remained substantially unable to perform the essential tasks of her pre-accident employment as a cook due to chronic pain and stress-induced swallowing difficulties.

The arbitrator also found a probable causal connection between the accident and the need for dental and nutritional treatments, ordering the insurer to pay the claimed expenses and reinstate the weekly benefits.