Amanda M. Lennox

The appellant insurer appealed an arbitrator's decision finding that the respondent insured sustained a catastrophic impairment.

The central issue was whether physical and psychological impairments could be combined to reach the 55% whole person impairment threshold under clause 2(1.1)(f) of the Statutory Accident Benefits Schedule.

The Director's Delegate dismissed the appeal, holding that the Schedule is unambiguous and permits the combination of physical and psychological impairments.

The Delegate found that excluding psychological impairments would be inconsistent with the remedial nature of the legislation and the inclusive definition of impairment.

The appellant insurer appealed a trial judgment allowing the Motor Vehicle Accident Claims Fund's action for restitution of statutory accident benefits paid to an injured passenger.

The appellant argued the Fund was required to proceed by arbitration under the Dispute Regulation rather than by a civil action.

The Court of Appeal dismissed the appeal, holding that while the Fund is an 'insurer' under the regulation, this was a 'proper case' for a restitution action because the parties had engaged in informal discussions past the 90-day arbitration notice period, making arbitration impossible.

The Court also held that the notice provisions of the regulation do not apply to civil restitution claims and that judge-made law regarding the Fund's status as an insurer applies retrospectively.