Tanja Wacyk

The applicant sought statutory accident benefits after slipping and falling on black ice in a parking lot.

She claimed she fell while exiting her vehicle and struck her head on the vehicle's step.

The insurer denied the claim, arguing the incident was not an "accident" under s. 3(1) of the Statutory Accident Benefits Schedule.

The arbitrator found the applicant's initial medical records did not mention her vehicle or hitting her head, and concluded she had safely exited the vehicle before slipping on the ice.

The arbitrator held that the ice was an intervening factor and the use or operation of the vehicle was not the direct cause of the impairment.

The application for arbitration was dismissed.

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

In a prior decision, the arbitrator found the applicant made a material misrepresentation, relieving the insurer of its obligation to pay benefits.

In this costs decision, the arbitrator ordered the applicant to pay the insurer's expenses.

The arbitrator noted the applicant's vague and contradictory evidence, as well as the calling of an unhelpful witness, unnecessarily prolonged the hearing.

The insurer's costs were slightly reduced to account for delays caused by interpretive services, resulting in a total award of $8,095.38.

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

The insurer terminated the benefits and sought to compel the applicant to attend examinations by an orthopaedic surgeon, a physiatrist, and a psychologist.

The insurer argued the applicant was precluded from proceeding to arbitration for failing to attend.

The arbitrator held that the insurer's notice of examination was deficient because it listed benefits not in dispute, and thus could not be relied upon to preclude arbitration.

The arbitrator further held that examinations by an orthopaedic surgeon and a physiatrist were reasonable and necessary, but a psychological examination was not, given the passage of time since any psychological issues were reported.

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

The insurer raised preliminary issues regarding whether all disputed treatment plans from the same clinic should be added to the existing arbitration, and whether the applicant's representatives should be required to provide signed, informed consents from the applicant.

The arbitrator ordered that all disputed treatment plans be added to the arbitration to avoid a multiplicity of proceedings, and required the applicant's representative to provide a signed 'Glinka' acknowledgement.

The applicant was a passenger on a public transit bus.

She alleged that as she was exiting the bus, the doors closed on her jacket and purse, and the bus moved, causing her injury.

She applied for statutory accident benefits.

The insurer denied the benefits and raised two preliminary issues: whether an "accident" occurred within the meaning of the Statutory Accident Benefits Schedule, and whether the applicant was precluded from proceeding to arbitration for failing to attend insurer's examinations.

The arbitrator found that the applicant's jacket and purse were caught in the doors, constituting an "accident".

Furthermore, the arbitrator held that the insurer's notice of examinations was defective because it failed to state the specific benefits to which the examinations related, as required by section 42(2) of the Schedule.

Therefore, the insurer could not rely on the notice to preclude the arbitration.

The applicant claimed statutory accident benefits following a motor vehicle accident and applied for arbitration after mediation failed.

The applicant and her representatives failed to attend the scheduled arbitration hearing, failed to comply with undertakings, and failed to serve documents.

The arbitrator dismissed the application as abandoned.

Finding that the applicant commenced the arbitration with no intention of proceeding, which constituted an abuse of process designed to pressure the insurer into settlement, the arbitrator ordered the applicant to pay the insurer $3,000 under section 282(11.2) of the Insurance Act, plus the insurer's expenses thrown away.

The applicant was injured in a motor vehicle accident and applied for arbitration after the insurer denied payment for an orthopaedic mattress.

The applicant and his counsel failed to attend two pre-hearings, and the applicant failed to attend the scheduled arbitration hearing.

The arbitrator dismissed the application as abandoned.

Finding the commencement of the arbitration to be vexatious and an abuse of process, the arbitrator ordered the applicant to pay the insurer $3,000 as an assessment under section 282(11.2) of the Insurance Act, plus $790.77 for the insurer's expenses thrown away.

The applicant was injured in a motor vehicle accident and received caregiver benefits, which the insurer subsequently terminated.

The applicant requested a Designated Assessment Centre (DAC) assessment but failed to attend or remain for scheduled appointments.

The Arbitrator found that the applicant did not make herself reasonably available for the assessment, rejecting her explanations regarding her mental state and lack of written notice.

As a result, the applicant was precluded from receiving caregiver benefits from the date of termination until she attends a DAC assessment, and barred from pursuing her claim at the upcoming arbitration if she fails to attend before then.

The applicant's counsel brought a motion to withdraw from the record in a statutory accident benefits arbitration, citing a breakdown in the solicitor-client relationship and an inability to contact the applicant.

The insurer did not oppose the withdrawal but brought a cross-motion to dismiss the arbitration as frivolous and vexatious and for costs.

The arbitrator granted the counsel's motion to withdraw, finding the procedural requirements were met.

The insurer's motion to dismiss was found to be premature and could not be entertained because the applicant had not been given notice of it.

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

The insurer refused to pay, raising a preliminary issue that the applicant made a material misrepresentation on her insurance application by failing to disclose her complete accident history.

The arbitrator found that the applicant knowingly failed to disclose prior accidents, which constituted a material misrepresentation that induced the insurer to enter into the contract.

Pursuant to section 30(2)(a) of the Statutory Accident Benefits Schedule, the insurer was relieved of its obligation to pay the claimed benefits.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them in 1998 based on a Med/Rehab DAC report.

The applicant applied for mediation in 2000 and subsequently for arbitration.

The insurer raised a preliminary issue arguing the application for arbitration was premature because the applicant had not submitted specific claims for expenses prior to mediation.

The arbitrator held that the insurer's 1998 notice refusing to pay further benefits constituted a "dispute" under section 71 of the SABS, triggering the right to proceed to dispute resolution.

The application was not premature.

The arbitration was adjourned pending a new Med/Rehab DAC assessment, and the applicant was ordered to particularize her claimed expenses.

The insurer brought a motion in an accident benefits arbitration seeking production of the applicant's discovery transcript and defence medical examination reports from a related tort action, as well as an order requiring the applicant to attend a psychiatric examination.

The arbitrator dismissed the motion, holding that the implied undertaking rule protected the tort documents from production in the arbitration, as the insurer failed to show that the interests of justice outweighed the applicant's privacy interests.

The arbitrator also found that a psychiatric examination was not reasonably required, given the late stage of the proceedings and the applicant's willingness to attend a psychological examination.

The insurer brought a motion seeking an order to compel a third-party psychologist to produce his rough clinical notes and other materials relied upon in his psychological assessment of the applicant.

The applicant did not oppose the motion and provided authorization for the release.

The third party did not attend the hearing.

The arbitrator found the materials relevant and ordered the third party to release all records pertaining to the applicant to the applicant's counsel.

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

The applicant sought benefits for the period until he returned to full-time work, arguing that a combination of physical pain, sleep apnea, and psychological distress rendered him substantially unable to perform his sedentary job.

The arbitrator found the applicant credible and held that the accident materially contributed to his deteriorating physical and mental condition.

The arbitrator concluded the applicant was substantially disabled from performing the essential duties of his employment during the disputed period and ordered the insurer to pay the benefits with interest.

The insurer brought a motion seeking relief from the implied undertaking rule to compel the production of the applicant's related tort file, including medical and financial documentation.

The applicant opposed the motion, arguing that the documents were protected by the deemed undertaking rule under Rule 30.1 of the Rules of Civil Procedure.

The arbitrator held that while arbitrators have the jurisdiction to grant relief from the implied undertaking rule under sections 20 and 22 of the Insurance Act, the insurer failed to demonstrate special circumstances or specific relevance to justify overcoming the presumption of privacy.

The motion for production was denied.

Following a preliminary issues hearing where the applicant was precluded from proceeding to arbitration due to limitation periods and failure to submit forms, the arbitrator determined the quantum of expenses payable to the insurer.

The applicant failed to respond to the insurer's Bill of Costs or the Commission's requests for submissions.

The arbitrator assessed the insurer's expenses at $2,656.49, finding the amount reasonable given the complexity of the preliminary issues and the applicant's conduct, which had previously been found to constitute an abuse of process.

The applicant sought statutory accident benefits following an incident where a limousine he was riding in allegedly drove over a curb.

The insurer terminated his income replacement benefits and sought repayment of all benefits paid, alleging the accident never occurred or the applicant was not injured.

The arbitrator found that the accident did occur and the insurer was not entitled to repayment.

However, the arbitrator dismissed the applicant's claim for ongoing income replacement benefits and further treatment, finding that his injuries from the subject accident had largely resolved and his ongoing disability was attributable to a subsequent accident.

The insurer was ordered to pay for two medical reports.

The applicant was injured in a motor vehicle accident while driving his estranged wife's vehicle.

The insurer denied statutory accident benefits, arguing under s. 30(1)(a) of the Schedule that the applicant ought reasonably to have known the vehicle was uninsured.

The arbitrator found that the insurer failed to meet its evidentiary burden to show that an ordinary, rational person in the applicant's situation would have known the vehicle lacked insurance.

The preliminary issue was resolved in favour of the applicant.

The Applicant was injured in a motor vehicle accident and sought payment for four medical assessments and reports under section 24 of the Statutory Accident Benefits Schedule.

The Insurer refused payment, arguing the reports were duplicative, deficient, or medical-legal in nature.

The Arbitrator found that the Insurer was not limited to its initial reasons for denial, but ultimately concluded that all four assessments were reasonable at the time they were requested and were obtained for the purpose of the Regulation.

The Arbitrator ordered the Insurer to pay for the assessments with interest, awarded the Applicant her arbitration expenses, and ordered a special award of 25 percent regarding two specific unpaid assessments for which the Insurer provided no reason for non-payment.

The applicant sought accident benefits following a 1994 motor vehicle accident.

The insurer brought a motion on preliminary issues, arguing the applicant was precluded from proceeding to arbitration due to his failure to submit an Application for Benefits within 90 days of receiving the forms, and for filing the Application for Arbitration beyond the two-year limitation period.

The applicant requested a sixth adjournment to retain counsel, which the arbitrator denied based on a history of delay and peremptory warnings.

The applicant then left the hearing.

Proceeding in his absence, the arbitrator found the applicant had no reasonable excuse for his non-compliance with the 90-day limit and that his arbitration application was out of time.

The arbitration was dismissed.

The arbitrator denied the insurer's request for a $3,000 award under s. 282(11.2) of the Insurance Act due to lack of notice, but awarded the insurer its expenses under s. 282(11) due to the applicant's abuse of process, with quantum deferred.