Allen Joshua Wynperle

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

Prior to the accident, she and her husband were equal partners in a trucking business.

Following the accident, she could no longer drive, and a replacement worker was hired.

The applicant argued her post-accident income should be calculated based on a 5% allocation of the business's net income, reflecting her diminished contribution.

The insurer argued for a 50% allocation, consistent with the pre-accident split.

The arbitrator agreed with the insurer, finding that a 50% allocation fairly reflected her true financial situation and avoided over-compensation.

However, the arbitrator found the insurer unreasonably withheld IRB payments for a period in 2008 after receiving requested documentation, and ordered a special award of $750.

The appellant insurer sought to appeal an arbitrator's interim order regarding the calculation of Capital Cost Allowance (CCA) for the respondent's self-employment income in determining income replacement benefits.

The Director's Delegate allowed the appeal to proceed, noting that the arbitrator failed to consider a significant prior appeal decision on the treatment of CCA.

A stay of the arbitrator's orders regarding the CCA calculation and a special award hearing was granted pending the appeal.

The applicant, a self-employed taxi driver, was injured in a rear-end motor vehicle accident and claimed statutory accident benefits.

The insurer paid income replacement benefits for the first 104 weeks but denied post-104 week benefits, arguing the applicant was not completely unable to engage in suitable employment.

The arbitrator found that the applicant's physical impairments, including neurologically-based low back pain, combined with cognitive and emotional difficulties, rendered him completely unable to work full-time in any suitable occupation.

The arbitrator ordered the insurer to pay post-104 week income replacement benefits, to be recalculated without improperly deducting capital cost allowance.

Furthermore, the arbitrator awarded a special award under section 282(10) of the Insurance Act, finding that the insurer unreasonably withheld benefits by failing to critically analyze the medical and accounting evidence and misapplying the legal test for complete inability.

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

After mediation failed, the applicant applied for arbitration and obtained medical reports from an orthopaedic surgeon and a chiropractor.

The parties settled the substantive issues but disputed whether the cost of the medical reports were payable as arbitration expenses.

The arbitrator found that the reports were commissioned in contemplation of the arbitration proceeding to meet the applicant's evidentiary burden, rather than as examination expenses under section 24 of the Schedule.

The insurer was ordered to pay $1,200 for each report as arbitration expenses under subsection 282(11) of the Insurance Act.

In a pre-hearing conference regarding a dispute over statutory accident benefits, the applicant sought the insurer's reasons for continuing to deny income replacement benefits and its response to her claim for a special award.

The insurer objected, arguing the request amounted to discovery, which is not provided for in the Commission's rules.

The arbitrator ordered the insurer to provide specific particulars of its response to the special award claim within 20 days of receiving the applicant's particulars, finding that meaningful pleadings are necessary to facilitate a fair and expeditious dispute resolution process.

The insurer brought a motion to stay the arbitration hearing on the basis that the claimant refused to attend an insurer's medical examination (IME) with a neuro-psychiatrist.

The claimant argued the request was neither reasonable nor timely, as it was made close to the hearing date and the insurer already had numerous assessments in its favour.

The arbitrator found that the insurer's request was not reasonably necessary, noting that the insurer had ample time to request the IME earlier and that the chosen doctor had already concluded from a paper review that the claimant's injuries were not accident-related.

The motion was dismissed and the arbitration was ordered to proceed.

The insurer appealed an arbitration order requiring it to pay for the insured's ongoing chiropractic and massage treatments following three motor vehicle accidents.

The insurer argued that the treatments provided only temporary pain relief and were not reasonable or necessary, relying on Designated Assessment Centre reports.

The Director's Delegate dismissed the appeal, finding that pain relief is a legitimate treatment goal and that the arbitrator did not err in law by accepting the evidence of the insured and his treatment team over the insurer's experts.

The applicant was injured in three motor vehicle accidents and sought statutory accident benefits for chiropractic and massage treatments.

The insurer denied the claims based on Designated Assessment Centre (DAC) reports which concluded the treatments were palliative and did not promote recovery.

The arbitrator held that pain relief is a legitimate medical goal and that treatments do not need to promote recovery to be considered reasonable and necessary.

The arbitrator ordered the insurer to pay for past and ongoing chiropractic and massage treatments, as well as interest on overdue benefits.

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

The parties settled all substantive issues prior to the arbitration hearing, including the location of a residual earning capacity assessment, but could not agree on the entitlement to arbitration expenses.

The arbitrator found that the application had merit and the applicant achieved some success by obtaining an assessment in her preferred location, even though the insurer did not concede the legal right to that location.

The arbitrator awarded the applicant her expenses of the arbitration proceeding.

The applicant sought an assessment of legal and agent's fees following the settlement of a dispute over statutory accident benefits.

The insurer disputed the amount of time claimed by the applicant's legal assistants and lawyer.

The arbitrator adopted a global approach to assessing the fees, finding that the time claimed was excessive for the single issue involved.

The insurer was ordered to pay $1,819 in fees and GST.

The insurer appealed an arbitration decision that reinstated the insured's income replacement benefits and ordered a $7,500 special award.

The insured developed spasmodic torticollis following a rear-end motor vehicle accident.

The Director's Delegate upheld the arbitrator's refusal to stay the hearing for a late-scheduled independent medical examination, finding the insurer's delay unreasonable.

The Delegate also affirmed the arbitrator's conclusion that the accident materially contributed to the insured's condition, and upheld the special award on the basis that the insurer unreasonably relied on a qualified Designated Assessment Centre report without arranging necessary neurological follow-up.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including weekly income benefits and the cost of physiotherapy and transportation.

The insurer denied benefits, arguing that the applicant's disabilities arose from a previous work-related injury for which she was receiving WCB benefits.

The arbitrator found that the applicant's pre-existing back injury was the principal cause of her inability to work, and dismissed the claim for weekly income benefits.

However, the arbitrator found it was reasonable for the applicant to undergo an initial 12-week physiotherapy program to alleviate neck symptoms, and ordered the insurer to pay for those treatments and associated transportation costs.

The applicant was awarded 50 percent of her arbitration expenses.

The appellant sought to appeal an arbitration order that dismissed his claim for statutory accident benefits after he failed to attend the arbitration hearing.

The notice of appeal was filed almost five months after the order, well beyond the 30-day limit.

The appellant requested an extension of time under section 283(3) of the Insurance Act, claiming he missed the hearing because he was misinformed about an adjournment and subsequently suffered a breakdown.

The Director's Delegate rejected the appellant's explanation as not credible and found no apparent grounds for granting relief on the merits of the claim.

The motion to extend the time was denied and the appeal was dismissed.

The applicant was injured in two motor vehicle accidents in 1993 and received statutory accident benefits.

She returned to work as a secretary for several months before her temporary position ended, after which she sought further weekly income benefits, a medical rehabilitation case manager, and active physiotherapy.

The arbitrator dismissed the claim for weekly income benefits, finding that the applicant's soft tissue and finger injuries were relatively minor and did not disable her from performing the essential tasks of her employment.

The request for a case manager was also denied as unnecessary.

However, the arbitrator ordered the insurer to pay for four months of active physiotherapy and granted a special award of 10 per cent of the physiotherapy cost, finding that the insurer had unreasonably withheld payment for this "pay now, dispute later" benefit.