26 total
Life insurance proceeds awarded to former spouse as named beneficiary despite separation agreement release.
The deceased and his first wife entered into a separation agreement requiring him to designate her as the beneficiary of a life insurance policy until March 1995.
He subsequently married the appellant and later developed Alzheimer's disease.
The deceased never revoked the first wife's beneficiary designation, and the appellant continued paying the premiums under a power of attorney.
After the deceased's death, the appellant claimed the policy proceeds, arguing unjust enrichment and seeking a constructive trust.
The Court of Appeal dismissed the appeal, finding that the beneficiary designation constituted a juristic reason for the enrichment and that the general release in the separation agreement did not override the Insurance Act requirements for changing a beneficiary.
Stroke caused by panic-induced blood pressure spike following a collision constitutes an accident under the SABS.
The applicant was found outside his truck after it struck three parked vehicles.
He suffered a severe stroke and later died.
His estate sought statutory accident benefits, arguing the stroke was caused by the collision or a panic-induced spike in blood pressure resulting from the collision.
The insurer argued the stroke occurred spontaneously prior to the collisions.
The arbitrator found that the applicant's panic reaction to the first impact caused a precipitous rise in blood pressure, which, combined with his susceptibility to stroke and possible head trauma, caused the stroke.
Therefore, the impairments were sustained as a result of an 'accident' under the Schedule.
Insurer's request for further neuropsychological assessment denied; payment of 104 weeks of benefits triggered LECB entitlement.
The applicant, who sustained a brain injury as a seven-year-old pedestrian in a motor vehicle accident, sought loss of earning capacity benefits (LECB).
The insurer brought a motion to compel a new neuropsychological assessment.
The arbitrator dismissed the insurer's motion, finding that the applicant had already undergone numerous neuropsychological assessments, her cognitive function had plateaued, and a new in-person assessment was not reasonably required.
On the preliminary issue, the arbitrator held that the insurer was precluded from disputing the applicant's entitlement to an offer for LECB because it had paid 104 weeks of education disability benefits based on a partial inability to carry on a normal life, thereby triggering entitlement under the Schedule.
Application for accident benefits dismissed and expenses awarded to insurer after applicant failed to attend hearing.
The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement, medical, and housekeeping benefits.
The applicant failed to attend the arbitration hearing or provide any evidence to support her claims.
The arbitrator relied on the insurer's medical evidence, which concluded the applicant suffered no objective impairment leading to disability.
The application was dismissed, and the applicant was ordered to pay the insurer's arbitration expenses.
Arbitration dismissed and expenses awarded to insurer after applicant failed to attend the hearing.
The applicant sought income replacement benefits following a motor vehicle accident.
The applicant failed to attend the arbitration hearing or provide any evidence to support her claim.
As the onus is on the applicant to prove entitlement to benefits, the arbitrator dismissed the claim.
The arbitrator ordered the applicant to pay $1,500 in expenses to the insurer, finding that commencing a proceeding and failing to pursue it caused unnecessary expenses.
Claims for death and funeral benefits dismissed as motor vehicle accident did not contribute to insured's death.
The late insured was involved in a motor vehicle accident while suffering from Stage IV metastatic lung cancer.
He died several months later.
His estate and family members applied for statutory accident benefits, including death benefits, funeral expenses, and the cost of installing a Jacuzzi, arguing that the accident-related injuries interrupted his cancer treatment and contributed to his death.
The arbitrator dismissed the claims, finding based on expert oncological evidence that the accident did not materially contribute to the progression of the cancer or the insured's death, which was inevitable due to the advanced disease.
The arbitrator also found that the stepson was not a dependant and that the Jacuzzi was neither a reasonable nor necessary medical or rehabilitation expense.