Stuart J. Mutch

The Applicant sought statutory accident benefits, including non-earner benefits, treatment plans, and examination costs, following a motor vehicle accident.

The insurer denied the claims.

The arbitrator found the Applicant's evidence regarding her pre-accident functioning to be unreliable and exaggerated, noting extensive pre-existing medical issues and a history of claiming a Disability Tax Credit.

Relying on the credible evidence of the insurer's medical experts, who found no objective evidence of accident-related impairment and noted pain magnification, the arbitrator concluded the Applicant did not suffer a complete inability to carry on a normal life.

All claims for benefits, treatment plans, and a special award were dismissed.

The Applicant was ordered to pay the insurer's expenses.

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

After failing to attend scheduled insurer examinations and failing to provide requested documentation, the applicant withdrew her claims two business days before the scheduled arbitration hearing.

The insurer sought its expenses.

The arbitrator found that the applicant had unduly prolonged the proceedings and failed to attend required examinations.

The arbitrator awarded the insurer its arbitration assessment fee and a portion of its legal expenses, totaling $8,862.04 inclusive of HST and disbursements.

The insurer raised a preliminary issue arguing that the insured was barred from proceeding to mediation and arbitration because he failed to attend a scheduled insurer's examination under section 44 of the Statutory Accident Benefits Schedule.

The arbitrator found that the examination had been cancelled by mutual consent because the insured had travelled to China, and the insurer made no subsequent attempts to reschedule it.

As there was no active examination for the insured to attend, he did not fail to comply with the Notice of Examination.

The insurer's motion was dismissed, and the insured was permitted to proceed to arbitration.

The applicant's representative, Yeung & Associates, brought a motion to withdraw as the representative of record in a statutory accident benefits dispute.

The arbitrator found that there had been a breakdown of communication in the solicitor-client relationship and that the applicant had apparently retained another representative.

The motion was granted, and Yeung & Associates was permitted to withdraw without terms.

The applicant claimed statutory accident benefits following an alleged motor vehicle accident.

In a prior preliminary issue hearing, it was determined that the applicant was not involved in the accident.

The insurer subsequently sought repayment of all benefits paid, alleging wilful misrepresentation.

The arbitrator found that the applicant's claim of being in the vehicle constituted wilful misrepresentation.

However, interpreting section 47 of the 1996 Schedule restrictively, the arbitrator held the applicant liable to repay only those benefits paid directly to him (housekeeping, attendant care, and caregiver benefits), and not medical and rehabilitation benefits paid to third parties.

The applicant was ordered to repay $13,904.19 plus interest and $10,266.88 in expenses.

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

The parties reached a settlement agreement, but the applicant failed to sign the release and ceased communicating with her counsel and the Commission.

Her counsel withdrew.

The applicant failed to attend the scheduled arbitration hearing.

The arbitrator dismissed the applicant's claims for failing to prove entitlement and awarded the insurer $1,130.90 in expenses, finding that the applicant's failure to participate prolonged the proceedings.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, claiming she sustained a catastrophic impairment due to a mental or behavioural disorder.

The sole issue was whether she suffered a marked impairment in the adaptability domain.

The arbitrator preferred the evidence of the applicant's experts, finding that the insurer's psychiatric assessment was based on incomplete facts.

The arbitrator concluded that the applicant's major depression and cognitive difficulties significantly impeded her ability to maintain activities of daily living, continue social relationships, and adapt to stressful circumstances, including parenting and employment.

The applicant was found to be catastrophically impaired within the meaning of the Schedule.

The applicants, injured in a 2008 motor vehicle accident, sought an interim order for funding of catastrophic impairment rebuttal reports in the amount of $26,352.00 each.

The insurer had partially approved the treatment plans for $8,000.00 per applicant based on a prior pre-hearing agreement.

The arbitrator found that the claim for funding fell under the 1996 Schedule, which restricts the insurer's funding obligation to portions of the report relevant to the denial.

Applying the Bernicky criteria, the arbitrator concluded the requested interim expenses were not shown to be reasonable and necessary for the conduct of the arbitration at this stage, leaving the issue of the additional assessments and their admissibility to the hearing arbitrator.

The motion was dismissed.

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

A preliminary issue was raised regarding whether the applicant was employed at the time of the accident, as he worked sporadically for a temporary employment agency.

The arbitrator found that the applicant had an ongoing relationship with the agency, had worked steadily in the months prior to the accident, and was on his way to the agency to seek work when the accident occurred.

The arbitrator concluded that the applicant was employed within the meaning of the Schedule at the time of the accident.

The insurer brought a motion for the production of police records in the possession of the Ministry of the Attorney General.

The Ministry consented to the production order subject to certain conditions and redactions.

The arbitrator found that the requirements of Rule 67.7 of the Dispute Resolution Practice Code were met, as the documents were reasonably required to ensure a just and fair hearing.

The motion was granted on consent.

The applicant, who suffered from paranoid schizophrenia and became an elective mute after a motor vehicle accident, applied for arbitration concerning accident benefits.

After his counsel withdrew, the applicant failed to attend a resumed pre-hearing and the scheduled arbitration hearing.

The insurer brought a motion to dismiss the claims.

The arbitrator dismissed the application for arbitration due to the applicant's failure to attend and present evidence, with no order as to expenses.

The applicant was injured when he fell from a transport truck while training as an unpaid driver.

He sought interim income replacement benefits from his auto insurer, Pafco, after his WSIB claim was denied.

Pafco brought a cross-motion to dismiss the arbitration, arguing the applicant was entitled to WSIB benefits.

The arbitrator dismissed the motion for interim benefits, finding the applicant failed to establish a prima facie case for the duration claimed and did not demonstrate an urgent financial need, as he was currently employed.

The cross-motion to dismiss the arbitration was also denied, as the issue of WSIB entitlement remained unresolved and was best left for a full hearing.

No special award or costs were granted.

The applicant applied for arbitration concerning her entitlement to statutory accident benefits following a motor vehicle accident.

Her counsel previously withdrew from the record after losing contact with her.

The applicant failed to attend the scheduled pre-hearing and the arbitration hearing.

The arbitrator dismissed the application as vexatious due to the applicant's failure to provide evidence or attend, and ordered the applicant to pay the insurer's expenses fixed at $750.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits from her insurer, including income replacement, attendant care, housekeeping, and medical/rehabilitation benefits.

The insurer denied several of the claims, leading to an arbitration hearing.

The arbitrator found that the applicant was substantially unable to perform the essential tasks of her pre-accident employment as a self-employed landscaper for the first 104 weeks, but did not meet the test for post-104 week income replacement benefits as she was capable of retraining for a sedentary occupation.

The arbitrator also awarded attendant care and housekeeping benefits for the first year post-accident, as well as certain medical benefits and examination costs.

The applicant's claim for a special award was dismissed, as the insurer's withholding of benefits was not unreasonable given the delayed provision of medical and financial information.

The applicant was injured in a motor vehicle accident and claimed attendant care benefits under a transitional policy.

The insurer brought a motion to determine whether the applicant was required to prove economic loss under subsection 3(7)(e) of the 2010 Schedule.

The applicant argued that his rights under the 1996 Schedule had vested at the commencement of the policy period.

The Arbitrator held that the right to benefits is contingent upon involvement in a motor vehicle accident and only vested on the date of the accident, which occurred after the 2010 Schedule came into force.

Therefore, proof of economic loss is required.

The applicant died of causes unrelated to a motor vehicle accident while his claim for accident benefits was pending.

The arbitration process was paused to allow for the appointment of an estate trustee.

After more than two years, the applicant's family confirmed they had no plans to appoint a representative.

The insurer brought a motion to dismiss the application for arbitration.

The arbitrator found the claims could not be pursued without a legally appointed representative and dismissed the application on consent, with no order as to expenses.

The applicant sought accident benefits following a motor vehicle accident.

After a settlement was reportedly reached at a pre-hearing discussion, the applicant failed to execute the settlement documents and ceased communicating with her counsel.

At the scheduled arbitration hearing, the applicant did not appear.

Her counsel was granted permission to withdraw from the record.

As no evidence was introduced to support the applicant's claims, the application was dismissed.

The applicant was ordered to pay $500 in expenses to the insurer for unduly prolonging the proceeding.

The insurer brought a motion to dismiss the applicant's claims for statutory accident benefits.

The applicant, who resided in the U.K. and was self-represented, failed to comply with production requests over a seven-month period and indicated she had no plans to attend the scheduled arbitration hearing in Toronto.

The arbitrator found that the applicant was not taking the arbitration process seriously and that the proceeding had become vexatious.

The application for arbitration was dismissed pursuant to Rule 68 of the Dispute Resolution Practice Code, with no order as to expenses.

The applicant, who was injured in a motor vehicle accident, sought an interim order requiring the insurer to fund a rebuttal catastrophic impairment assessment.

The insurer had already paid the $50,000 maximum in medical and rehabilitation benefits for non-catastrophic injuries.

The arbitrator found that while the applicant met the criteria for an interim expense award—raising a bona fide issue, demonstrating the expense was reasonable and necessary, and showing financial inability to pay—the request was barred by the statutory limits.

Because the cost of assessments is included in the medical and rehabilitation benefits limit under the Schedule, the arbitrator could not order the insurer to exceed the $50,000 cap.

The motion was dismissed with no order as to expenses.

The applicant was injured in a motor vehicle accident and applied for arbitration at the Financial Services Commission of Ontario after a dispute with the insurer over accident benefits.

The applicant failed to communicate with his counsel or attend the pre-hearing and hearing.

At the hearing, the applicant's counsel successfully moved to withdraw from the record.

The insurer moved to dismiss the application due to the applicant's failure to participate.

The arbitrator dismissed the application in its entirety and awarded the insurer $495 in expenses for counsel fees, rescinding an initial award for the arbitration filing fee.