Brian Cintosun

The insurer brought a motion to set off $37,839.76 it owed to the applicant for accident benefits against $40,357.10 the applicant owed to the insurer for arbitration expenses.

The arbitrator found she had jurisdiction under section 279(4) of the Insurance Act to order a set-off to sort out the net effect of the arbitration orders.

The motion was granted, resulting in a net amount of $2,517.34 owing by the applicant to the insurer, with interest on the benefits suspended as of the date the expenses order crystallized.

The Insurer sought its expenses of $75,343.92 following an arbitration where success was divided but predominantly in favour of the Insurer.

The Applicant also sought his expenses.

The Arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code, noting the Insurer's written offer to settle for $100,000, which exceeded the Applicant's recovery.

The Arbitrator also noted the Applicant's conduct in failing to comply with production orders, which prolonged the proceedings.

The Arbitrator reduced the Insurer's claimed legal fees and disbursements to reflect the Applicant's partial success and the applicable hourly rates, awarding the Insurer $40,357.10 in expenses.

The Applicant's request for expenses was dismissed.

The Applicant was involved in a minor rear-end motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment, income replacement benefits, attendant care, housekeeping, and medical benefits.

The arbitrator found that the Applicant had provided an inaccurate narrative of the accident to his medical assessors, falsely claiming he had struck his head and lost consciousness.

Relying on the insurer's medical experts, the arbitrator concluded the Applicant did not sustain a catastrophic impairment, as his whole person impairment was 24% and his mental/behavioural impairments were mild to moderate.

The claim for ongoing income replacement benefits was dismissed because the Applicant had returned to work shortly after the accident.

The arbitrator granted the claims for attendant care benefits for the first 104 weeks and the cost of psychological examinations, but dismissed the claims for housekeeping benefits and an orthopedic mattress due to lack of proof and exaggeration.