Aldo Picchetti

Following an unsuccessful arbitration for statutory accident benefits, the insurer sought its expenses.

The applicant argued the insurer was precluded from claiming expenses due to a four-month delay in requesting the assessment.

The arbitrator found the delay was a technical breach that caused no prejudice to the applicant.

In assessing the quantum of expenses, the arbitrator reduced the insurer's claim from $12,339.87 to $6,000, noting that the applicant's case raised a novel issue regarding the Pre-approved Framework Guideline for Whiplash Associated Disorder Grade II injuries, which warranted a reduction in the costs payable.

Following a successful claim for statutory accident benefits, the applicant sought his expenses for the arbitration hearing.

The insurer argued that each party should bear their own costs due to mixed results and that the claimed amount was excessive.

The arbitrator found the applicant was substantially successful and entitled to his reasonable expenses.

The arbitrator assessed the fees for the applicant's student-at-law and supervising lawyer, as well as disbursements including expert witness fees, awarding a total of $7,904.80 plus GST.

The applicant was walking across a street when she heard a fire truck siren and saw the vehicle approaching.

Frightened, she quickened her pace to get out of the way and fell, sustaining serious injuries.

She applied for statutory accident benefits, which the insurer denied on the basis that she was not injured in an 'accident' as defined in section 2(1) of the Schedule.

On a preliminary issue hearing, the Arbitrator found that the use and operation of the fire truck was the dominant feature in the incident and the direct cause of the applicant's injuries.

The Arbitrator concluded that the applicant was injured as a result of an accident and is entitled to proceed with her claim for benefits.

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

After filing for arbitration, the applicant's counsel lost contact with him, and he failed to participate in the proceedings or attend the pre-hearing.

The insurer brought a motion to dismiss the arbitration without a hearing under Rule 68 of the Dispute Resolution Practice Code, or alternatively, to deem it withdrawn under Rule 70.

The arbitrator found insufficient evidence of bad faith to dismiss under Rule 68 but concluded the applicant had abandoned his claim.

The arbitration was deemed withdrawn under Rule 70, and the applicant was ordered to pay $1,000 in expenses to the insurer.

The applicant was injured in a motor vehicle accident and applied for arbitration regarding his entitlement to income replacement and medical benefits.

The parties settled the substantive issues prior to the hearing for a lump sum of $5,000, but could not agree on the quantum of expenses payable to the applicant.

The arbitrator assessed the applicant's expenses, allowing his legal fees in full as reasonable, but reducing several claims for disbursements, including medical reports and photocopies, on the basis that they were partially incurred for the applicant's concurrent tort action or were excessive.

The insurer was ordered to pay $8,110.57 in total expenses.

Following the dismissal of both the insurer's appeal and the insured's cross-appeal regarding statutory accident benefits, the parties disputed entitlement to appeal expenses.

The Director's Delegate ordered the insurer to pay the insured's appeal expenses, finding that the insured was successful on the main issue of entitlement to income replacement benefits.

The insurer was ordered to pay $7,500 in appeal expenses, representing a reasonable global assessment of the legal fees incurred to respond to the fact-based appeal.

The applicant sought production of the insurer's adjusting notes up to the date of mediation in her claim for income replacement benefits following a motor vehicle accident.

The insurer had terminated benefits on the basis that her injuries were limited to a Grade II Whiplash Associated Disorder.

The applicant argued the notes were relevant to her claim for a special award, as medical evidence suggested her injuries fell outside the WAD II framework.

The arbitrator granted the motion, finding sufficient foundation to support the applicant's entitlement to review the claims handling process.

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 sought to withdraw his application for arbitration of statutory accident benefits in order to proceed by court action.

The insurer consented to the withdrawal on the condition that the applicant pay its assessment fee and arbitration expenses.

The arbitrator permitted the withdrawal and ordered the applicant to pay $500 towards the insurer's arbitration expenses, recognizing that the applicant's change of process caused wasted expenses.

However, the arbitrator declined to order the applicant to pay the insurer's $3,000 assessment fee, finding that the decision to withdraw and proceed in court did not constitute an abuse of process.

Following a decision dismissing the applicant's claims for medical and rehabilitation benefits due to a lack of causation, both parties sought their expenses of the arbitration.

The arbitrator found that the applicant's claim was brought in good faith and awarded him 75 percent of his legal fees and 100 percent of his assessable disbursements.

The arbitrator reduced the claimed counsel hours from 90 to 40, set the hourly rate at $110, and allowed the full $1,100 cost of an occupational therapist's report.

The applicant was struck by a slow-moving vehicle while walking in a parking lot and claimed ongoing income replacement benefits for chronic pain.

The insurer terminated benefits based on an independent medical examination finding no objective injury.

At arbitration, the arbitrator found the applicant's subjective complaints of disabling pain were not credible, noting inconsistencies in her testimony regarding child care, her refusal of recommended treatments, and surveillance video showing her walking briskly and moving freely.

The arbitrator concluded the applicant failed to prove she was substantially disabled from performing the essential tasks of her employment and dismissed the claim.

The applicant was injured in a motor vehicle accident and sought ongoing caregiver benefits and housekeeping expenses after the insurer terminated them.

The arbitrator found that the applicant met the test for a partial inability to carry on a normal life and a substantial inability to engage in pre-accident caregiving activities for a period following the termination, entitling her to caregiver benefits until August 1997, at which point video surveillance demonstrated she had regained significant capacity.

The arbitrator also awarded housekeeping expenses for varying hours per week up to April 1998, but declined to order a special award against the insurer.

The applicant was injured in a minor motor vehicle accident and claimed medical and rehabilitation benefits for various assistive devices, including a boat, snowmobile, and ATV, to help him function at his remote cottage.

The insurer denied the claims, arguing the need for the devices arose from a pre-existing back condition.

The arbitrator found that the applicant had a long history of severe back problems, including a prior surgery, and that the minor car accident did not materially contribute to his need for the assistive devices.

The claim for benefits was dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them, claiming she could return to her pre-accident work as a piecework sewing machine operator.

The arbitrator found that the applicant's permanent hand injury prevented her from performing the rapid, repetitive movements required for her job, entitling her to ongoing benefits.

The arbitrator also determined that the applicant was an employee rather than an independent contractor, calculating her benefits based on a weekly salary of $275.

The applicant's claim for a special award was dismissed as the insurer's initial termination was based on reasonable medical evidence.

The applicant sought income replacement and supplementary medical benefits following a 1994 motor vehicle accident.

The insurer terminated benefits, arguing the applicant could return to his pre-accident employment as a shipper/receiver.

The arbitrator found that the applicant suffered only soft-tissue injuries, not a cervical disc herniation, and that these injuries did not substantially disable him from his essential tasks.

The applicant's credibility was severely undermined by his failure to disclose pre-existing injuries, inconsistent symptom reporting, and surveillance evidence.

The insurer's claim for repayment of benefits due to undisclosed workers' compensation benefits was dismissed because the WCB benefits were permanent, not temporary.

The applicant's claims were dismissed, but he was awarded half his arbitration expenses.

The applicant, who suffered serious injuries in a motor vehicle accident, sought funding for a MacIntosh laptop computer to assist with his university computer science studies as a rehabilitation measure under section 40 of the Statutory Accident Benefits Schedule.

The insurer agreed a computer was needed but argued an IBM-compatible desktop was sufficient.

The arbitrator found that a laptop was reasonably required due to the applicant's physical limitations, but agreed with the insurer's expert that an IBM-compatible machine was adequate for his coursework.

The arbitrator also granted a special award of 25% under section 282(10) of the Insurance Act, finding that the insurer unreasonably delayed providing the computer and failed to cooperate with the applicant's rehabilitation efforts.

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

The insurer refused to pay certain invoices for rehabilitation services, and mediation failed.

The applicant subsequently signed a full and final release settling her claims for a lump sum.

She later applied for arbitration to claim the disputed rehabilitation expenses.

The arbitrator held that the release was a valid agreement that finally disposed of the claim, precluding the applicant from commencing arbitration.

Finding the arbitration to be an abuse of process, the arbitrator denied the applicant's expenses and ordered her to pay the insurer's assessment fee.