Stuart Mutch

The Applicant sought accident benefits for medical treatment plans and assessments following a motor vehicle accident.

The insurer denied the claims, arguing the Applicant's injuries were minor, pre-existing, or caused by a subsequent workplace accident.

The arbitrator applied the material contribution test and found that the motor vehicle accident did not materially contribute to the Applicant's physical complaints, which were largely attributable to a pre-existing history of back pain and a significant workplace injury that occurred days after the motor vehicle accident.

The arbitrator dismissed the claims for a chronic pain program, physiotherapy, and an orthopaedic assessment, finding them not reasonable and necessary.

However, $300 was awarded for a psychological assessment report.

The Applicant's claim for a Special Award was dismissed, as the insurer did not unreasonably withhold payments.

The Applicant was ordered to pay $11,863.52 for the insurer's expenses due to the insurer's near-total success in the proceeding.

The applicant was injured in three motor vehicle accidents (2003, 2005, 2006) and sought statutory accident benefits, including a determination of catastrophic impairment.

The arbitrator found that claims arising from the 2005 and 2006 accidents were procedurally barred due to non-compliance with notice and limitation periods.

However, the applicant was found to be catastrophically impaired as a result of the 2003 accident, having sustained a marked impairment in the domain of adaptability due to severe depression and psychotic features.

The arbitrator awarded ongoing housekeeping and home maintenance benefits but dismissed claims for attendant care, a psychological treatment plan, and a special award.

The applicant sought expenses following an arbitration where she had mixed success in claiming statutory accident benefits.

The insurer argued that it enjoyed a greater degree of success and that the applicant unnecessarily prolonged the proceeding by calling six expert witnesses and being tardy in providing medical and financial records.

The arbitrator found that while the applicant's success was mixed, she was forced to proceed with the arbitration to obtain any benefits, as the insurer refused to acknowledge liability until the eve of the hearing.

The arbitrator awarded the applicant her reasonable expenses, with some reductions for unnecessary testimony and excessive preparation time, totaling $20,637.64 inclusive of fees and disbursements.

The applicant was injured in a motor vehicle accident and claimed attendant care, housekeeping, and caregiver benefits from her insurer under a transitional policy.

The central legal issue was whether the new 'incurred' definition in the 2010 Statutory Accident Benefits Schedule, which requires non-professional service providers to demonstrate an economic loss, applied to her claims.

The arbitrator held that the applicant's rights vested on the date of the accident, meaning the 2010 Schedule's definition of 'incurred' applied.

Because the applicant's family members could not demonstrate a quantifiable economic loss, the claims for attendant care and caregiver benefits were denied.

However, the applicant was awarded partial housekeeping benefits for services provided by professional cleaners during the period she was substantially disabled from performing those tasks.

The applicant claimed statutory accident benefits, alleging he was injured when a parked van he was occupying was rear-ended by another vehicle.

The insurer denied the claim on the basis that the applicant was not involved in an accident.

At a preliminary issue hearing, the arbitrator found the applicant and his witnesses lacked credibility due to significant inconsistencies in their evidence.

Relying on the testimony of an independent witness and a police officer, the arbitrator concluded that the van was unoccupied at the time of the collision.

Consequently, the applicant was not involved in an accident as defined in section 2(1) of the Schedule.