Shemin Manji

The Applicant was injured in a motor vehicle accident and received weekly income benefits until the Insurer terminated them, claiming she was no longer substantially unable to perform the essential tasks of her occupation.

The Applicant, a self-employed vocal teacher, sought benefits for an additional period.

The arbitrator found that while the Applicant continued to experience pain and discomfort, it did not substantially interfere with her ability to perform the essential tasks of her part-time occupation as a vocal teacher.

The claim for weekly income benefits was dismissed, but the Applicant was awarded her arbitration expenses.

The insurer moved for an order compelling the insured to attend a psychological examination pursuant to subsection 23(2) of the Statutory Accident Benefits Schedule.

The insured argued the insurer's right to require an examination expired after mediation.

The arbitrator held that the insurer was entitled to require the examination to assess the ongoing claim for weekly benefits.

However, the arbitrator concluded that she lacked the express or implied statutory authority under the Insurance Act or the Schedule to compel the insured to attend the examination.

The applicant was injured in a motor vehicle accident while a passenger on a bus and received weekly income benefits.

She returned to work but later resigned, claiming an inability to perform her essential tasks due to accident-related injuries.

The arbitrator found that the applicant did not suffer a substantial inability to perform the essential tasks of her employment and denied ongoing benefits.

The arbitrator also ordered the applicant to repay benefits received while she was working, as she failed to disclose her return to work.

The insurer's request for a special award for a frivolous application was denied, and the applicant was awarded her arbitration expenses.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits more than two years later.

The insurer denied the claim due to the delay.

The applicant argued the insurer was estopped from relying on the limitation period or had waived it.

The arbitrator found no estoppel or waiver, and held that the failure to submit the application within two years invalidated the claim, preventing the applicant from proceeding to arbitration.

The applicant was awarded expenses for the preliminary hearing.

The applicant was injured in a motor vehicle accident and received weekly statutory accident benefits for 18 months before the insurer terminated them.

The applicant sought arbitration, claiming continued entitlement to weekly benefits on the basis of a substantial inability to perform his essential tasks.

The arbitrator found that the applicant's condition had improved significantly and that his pain did not substantially impair his ability to perform his essential tasks during the disputed period.

The claim for weekly benefits was dismissed, but the applicant was awarded his arbitration expenses.

The insurer sought to raise issues regarding the repayment and ongoing entitlement to weekly income benefits in an arbitration initiated by the insured.

The insured had only referred the calculation of the quantum of benefits and transportation expenses to arbitration.

The arbitrator held that the insurer could not expand the scope of the arbitration to include issues that did not naturally or consequentially flow from the specific matters referred by the insured.

The insurer's request to add these issues was dismissed.

The applicant sought an interim award of expenses for clinical notes and a medical-legal report under section 282(11.1) of the Insurance Act.

The insurer argued the section did not apply retrospectively to proceedings commenced before January 1, 1994.

The arbitrator held that the section applies immediately to all ongoing proceedings.

Applying a three-part test, the arbitrator found the application raised a bona fide issue, the expenses were necessary and reasonable, and the applicant was unable to carry the costs until the hearing.

The arbitrator awarded $800 in interim expenses.