Shemin N. Manji

The applicant was injured in a motor vehicle accident and claimed income replacement benefits.

The insurer argued that the applicant's request for arbitration was barred by the two-year limitation period under the Insurance Act and the Statutory Accident Benefits Schedule.

The arbitrator found that the insurer's initial assessment forms did not constitute a clear and unequivocal refusal to pay benefits, as they requested further information to calculate the benefits.

The limitation period did not begin to run until the insurer explicitly denied the claim later.

Therefore, the applicant was not precluded from proceeding to arbitration.

Expenses were awarded to both parties for different hearing dates due to counsel's failure to attend.

The applicant was injured in a motor vehicle accident and received weekly income replacement benefits until the insurer stopped payments.

The insurer argued that the applicant's subsequent applications for mediation and arbitration were barred by the two-year limitation period under the Insurance Act and the Statutory Accident Benefits Schedule.

The arbitrator found that the insurer's communications did not constitute a clear and unequivocal refusal to pay benefits, nor did the insurer provide the requisite notice under section 64(2) of the Schedule.

Consequently, the limitation period had not started to run, and the applicant was not precluded from proceeding to mediation and arbitration.

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

The insurer moved to dismiss the arbitration on the basis that the applicant had already commenced a court proceeding and had failed to mediate the issues in dispute.

The arbitrator found that the application was premature because the applicant had not sought mediation, which is a mandatory prerequisite under the Insurance Act.

The arbitration was dismissed as an abuse of process due to the applicant's counsel's repeated failure to comply with undertakings to withdraw the court action and mediate the claims.

The applicant was ordered to pay the insurer's $3,000 assessment fee and $609.37 in legal expenses.