William J. Renahan

The applicant was injured in a motor vehicle accident and his claims for statutory accident benefits were dismissed in a previous arbitration decision.

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

Applying the criteria under Ontario Regulation 664, the arbitrator found the insurer was completely successful and awarded $12,112.66 in fees and disbursements.

The applicant was struck by a vehicle and claimed statutory accident benefits, including attendant care and housekeeping benefits beyond the 104-week mark.

The insurer terminated these benefits on the basis that the applicant did not suffer a catastrophic impairment.

The arbitrator reviewed the medical evidence, including a Designated Assessment Centre (DAC) assessment, and found that the applicant's whole person impairment was 30 per cent, falling short of the 55 per cent threshold required for a catastrophic impairment.

The arbitrator also found no evidence of a class 4 or 5 mental or behavioural disorder.

The claims for attendant care, housekeeping, and auto repair expenses were dismissed, and the applicant was ordered to pay the insurer's arbitration expenses.

The applicant applied for arbitration at the Financial Services Commission of Ontario after the insurer refused to pay statutory accident benefits following a motor vehicle accident.

Prior to the hearing, the applicant's counsel was removed from the record, noting the applicant had left the country and was no longer interested in the arbitration.

The applicant failed to appear at the scheduled hearing.

Consequently, the arbitrator dismissed the application for arbitration.

The arbitrator ordered the applicant to pay the insurer's arbitration expenses in the amount of $2,096.55, disallowing a claim for travel time and the filing fee.

Following the dismissal of the applicant's arbitration for statutory accident benefits, the insurer sought costs against the applicant's representative personally under section 282(11.2) of the Insurance Act.

The insurer alleged that it paid the representative $342 for documents that were never provided.

The representative did not respond to the costs submissions.

The arbitrator accepted the uncontradicted allegations, found that the representative caused the insurer to incur expenses without reasonable cause, and ordered the representative to personally pay $342 to the insurer.

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

The insurer paid a minimal income replacement benefit based on pre-accident income but failed to assess the applicant's post-accident self-employment business losses.

The arbitrator found that the insurer unreasonably delayed sending an accountant to review the applicant's business records, despite knowing the applicant's brain injury impaired his ability to maintain organized records.

The arbitrator awarded interest on the overdue income replacement benefits and held that the applicant was entitled to a special award under section 282(10) of the Insurance Act.

Following an arbitration decision where the applicant recovered approximately $1,000, the insurer sought its expenses.

The insurer had made a settlement offer of $7,500 four months prior to the hearing, which the applicant rejected.

The arbitrator considered the criteria under Ontario Regulation 664 and ordered the applicant to pay half of the insurer's expenses, noting the importance of encouraging settlement.

The arbitrator also ruled that court reporter's fees are not an allowable disbursement under the tariff.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them after 104 weeks.

The applicant sought arbitration, claiming a complete inability to engage in any employment for which she was reasonably suited.

The arbitrator reviewed the applicant's education, training, and work history, noting she primarily worked part-time.

Relying on the consensus of the applicant's own medical experts that she could return to part-time sedentary work, the arbitrator found she did not meet the test for complete inability to work.

The application for income replacement benefits and a special award was dismissed.

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

He returned to his pre-accident employment for over three years before being laid off due to lack of work, and later worked another job for six months before being laid off again.

He subsequently claimed weekly income benefits, arguing he was continuously disabled.

The arbitrator dismissed the application, finding that the applicant's successful return to suitable employment for several years demonstrated he was not continuously prevented from engaging in suitable employment as required by section 12(5)(b) of the Schedule.

Claims for a special award and assessment fees were also dismissed.

The applicant sought arbitration for various statutory accident benefits following a motor vehicle accident.

Neither the applicant nor his representative appeared at the hearing.

The arbitrator dismissed the application for arbitration due to the absence of evidence.

The insurer sought expenses, including the assessment fee, but the arbitrator noted the statutory authority to award the assessment fee had been repealed.

The arbitrator ordered the applicant to pay $1,500 in expenses.

The issue of whether the applicant's representative should personally pay $342 in disbursements was deferred to allow the representative an opportunity to make written submissions as required by the Insurance Act.

The applicant's representative brought a motion to withdraw from the arbitration.

The insurer sought an order requiring the representative to personally pay costs previously awarded against the applicant, alleging the representative violated the Code of Conduct.

The arbitrator permitted the withdrawal on consent.

Finding that the representative made deliberate misrepresentations to the tribunal and failed to produce documents, the arbitrator applied section 282(11.2) of the Insurance Act and ordered the representative to personally pay $1,500 in expenses to the insurer.

The applicant sought interim housekeeping and income replacement benefits pending arbitration of his claim arising from a motor vehicle accident.

The arbitrator applied the three-part test for interim mandatory orders, requiring the applicant to establish a strong prima facie case, irreparable harm, and that the balance of convenience favoured granting the relief.

The arbitrator found the applicant failed to establish it was more probable than not he would succeed at the hearing, failed to demonstrate irreparable harm given the availability of an earlier hearing date, and found the balance of convenience favoured the insurer.

The motion for interim benefits was dismissed.

The applicants, who were injured in a motor vehicle accident, brought a motion for interim income replacement benefits after the insurer terminated their benefits.

The arbitrator found that the applicants failed to establish the requisite urgency for an interim order, noting that they had previously consented to or requested adjournments of their hearing dates.

The motion for interim benefits was dismissed.

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

The applicant claimed ongoing disability due to a knee injury (a torn ACL) and sought further benefits, interest, and a special award.

The arbitrator found that the applicant's knee pain was not disabling and that the ACL injury was not caused by the accident, relying on medical evidence that the applicant could work without surgery.

The claim for ongoing benefits was dismissed.

However, the arbitrator awarded interest on late payments made prior to termination and a small amount for a four-day deficiency in the notice of termination.

The claim for a special award was dismissed as the insurer's conduct was not unreasonable.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After failing to comply with production orders and causing an adjournment, the applicant failed to appear at the rescheduled arbitration hearing.

The arbitrator dismissed the application for arbitration.

Finding that the applicant commenced an arbitration that was an abuse of process and frivolous by putting the insurer to the expense of responding and then failing to follow through without notice, the arbitrator ordered the applicant to pay the insurer $3,000 pursuant to subsection 282(11.2) of the Insurance Act, plus $535 for arbitration expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits.

He returned to work for several years before being laid off and claiming benefits again.

The insurer argued his return to work disqualified him as he was not 'continuously prevented' from engaging in suitable employment under s. 12(5)(b) of the Schedule.

The arbitrator held that whether the applicant was continuously prevented from working is a question of fact requiring full evidence, and that under s. 16(2), the applicant bears the burden of rebutting the presumption that his return to work for more than 90 days makes him ineligible for further benefits.

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

The insurer refused to pay income replacement benefits because the applicant failed to attend an independent medical examination.

The arbitrator held that the applicant was not barred from proceeding to arbitration because she had no outstanding claim for benefits when the examination was requested, and she had valid reasons for distrusting the insurer's doctors based on prior examinations.

The arbitrator also determined that pre-accident self-employment losses are not deducted from employment income when calculating gross income for income replacement benefits.

The applicant's claim for a special award was dismissed because her late application prejudiced the insurer.

The applicant, a part-time supply teacher, was injured in a motor vehicle accident and claimed a loss of earning capacity benefit.

The parties disagreed on the method to convert her part-time pre-accident income to full-time income under section 86 of the Statutory Accident Benefits Schedule.

The arbitrator found that the reasonable method for establishing the number of hours in a regular work week for a full-time teacher must take into account the fixed number of school days (194) and the corresponding annual salary.

The arbitrator determined the applicant's gross annual income to be $36,714, rejecting the applicant's argument for a higher amount based on her personal and vocational characteristics.

Following the dismissal of the applicant's claim for statutory accident benefits, the insurer sought its expenses of the arbitration proceeding.

The arbitrator found that the applicant was completely unsuccessful and had failed to provide any reliable independent evidence of payments to a replacement worker, rendering the proceeding borderline frivolous.

The applicant was ordered to pay the insurer's expenses in the amount of $3,686.25.

The applicant sought to withdraw her Application for Arbitration after conceding she failed to attend an insurer's medical examination, which precluded her from proceeding under section 50 of the Statutory Accident Benefits Schedule.

The insurer consented to the withdrawal but sought a $3,000 award under subsection 282(11.2) of the Insurance Act, arguing the application was frivolous, vexatious, or an abuse of process.

The arbitrator permitted the withdrawal and declined to make the award, finding the applicant did not know the insurer was relying on the section 50 defence until the pre-hearing discussion.

Each party was ordered to bear its own expenses.

The applicant sought statutory accident benefits for housekeeping and home maintenance expenses following a motor vehicle accident.

At the arbitration hearing, the applicant failed to appear, and his agent was permitted to withdraw from the record.

The arbitrator dismissed the application and ordered the applicant to pay the insurer's expenses.

Furthermore, finding that the applicant's failure to attend after knowingly putting the insurer to the expense of responding constituted an abuse of process, the arbitrator ordered the applicant to pay the insurer $3,000 for its filing fee pursuant to subsection 282(11.2) of the Insurance Act.