Brian Leck

The insurer appealed an arbitrator's decision awarding the insured her arbitration expenses and refusing to order her to reimburse the insurer's assessment, despite finding that the insured was not entitled to further benefits and lacked credibility.

The Director's Delegate dismissed the appeal, holding that the arbitrator did not exercise her discretion unreasonably in finding that the application was not frivolous, vexatious, or an abuse of process.

The appellant appealed an arbitrator's decision denying her claim for weekly income benefits and refusing to award her arbitration expenses.

The arbitrator found that the appellant had deliberately withheld information from her doctors about a previous back injury.

On appeal, the appellant argued that under the McCormick principles, she should be awarded expenses because her claim was not found to be frivolous or vexatious, nor did her conduct unreasonably prolong the proceedings.

The Director's Delegate dismissed the appeal, holding that the arbitrator's discretion to deny expenses was exercised reasonably given the appellant's deliberate misrepresentation of her pre-accident health, which went to the heart of her evidence.

The applicant, a passenger on a TTC bus involved in a collision, sought statutory accident benefits including weekly benefits, housekeeping expenses, and a special award.

The arbitrator found the applicant's evidence unreliable and fraught with misrepresentations, preferring the insurer's medical evidence that the applicant was malingering and did not suffer from chronic pain syndrome or a disabling disc injury.

The claims for benefits were dismissed.

Finding the arbitration to be an abuse of process due to the applicant's deliberate misrepresentations, the arbitrator ordered the applicant to pay $1,000 in expenses to the insurer.

The applicant was injured when she fell on a streetcar and received weekly income benefits until the insurer terminated them.

She applied for arbitration to reinstate the benefits, claiming ongoing soft tissue injuries and pain that prevented her from working as a homemaker.

The arbitrator found the applicant's evidence regarding her injuries to be inconsistent, contradictory, and unreliable, noting she had deliberately concealed a prior back injury from several examining doctors.

Consequently, the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her employment.

The claim for ongoing benefits was dismissed, and the applicant was denied her hearing expenses due to her dishonesty, though the insurer's request for a special assessment was also denied.

The applicant claimed statutory accident benefits following a minor collision involving a TTC bus.

Neither the applicant nor her representative attended the arbitration hearing.

Based on the evidence presented by the insurer, including testimony from the bus driver and inconsistencies in the applicant's prior statements, the arbitrator found that the applicant was not injured in the accident.

The application was dismissed as frivolous, and the applicant was ordered to pay the insurer $1,000 to reimburse its filing fee under subsection 282(11.2) of the Insurance Act.

The applicant was injured in a motor vehicle accident while a passenger on a bus, suffering a partial amputation of his right middle finger.

He received weekly income benefits until the insurer terminated them, prompting him to seek ongoing benefits, claiming he was substantially unable to perform his pre-accident job as a light assembler due to hypersensitivity and psychological issues.

The arbitrator found that the applicant was capable of performing his pre-accident job and other suitable employment, noting significant evidence of malingering and a lack of motivation to rehabilitate.

The application for ongoing benefits was dismissed, and the applicant was denied his arbitration expenses, though the insurer's request for a penalty for a frivolous proceeding was also denied.

The applicant was injured in a motor vehicle accident while a passenger on a bus and received weekly income benefits.

She returned to work but later resigned, claiming an inability to perform her essential tasks due to accident-related injuries.

The arbitrator found that the applicant did not suffer a substantial inability to perform the essential tasks of her employment and denied ongoing benefits.

The arbitrator also ordered the applicant to repay benefits received while she was working, as she failed to disclose her return to work.

The insurer's request for a special award for a frivolous application was denied, and the applicant was awarded her arbitration expenses.

The applicant was injured on a transit bus and received weekly income benefits until they were terminated.

She applied for arbitration to reinstate the benefits, claiming a substantial inability to perform the essential tasks of her employment as a ceramic factory worker.

The arbitrator found the applicant's testimony regarding her pain and inability to work lacked credibility, preferring the objective medical evidence of orthopaedic specialists and surveillance footage showing her performing physical tasks without apparent difficulty.

The application for further weekly income benefits was dismissed, though the applicant was awarded her arbitration expenses.

The applicant was injured in a motor vehicle accident while driving a bus in the course of his employment.

He elected to sue the at-fault third party rather than claim workers' compensation benefits, and subsequently applied for interim no-fault benefits under Section 21 of the No-Fault Benefits Schedule.

The insurer denied the claim under Section 20, arguing that the applicant was entitled to workers' compensation benefits.

The arbitrator held that Section 21 only applies to bona fide threshold claims where damages are recoverable, not to cases where a lawsuit is initiated solely to qualify for no-fault benefits.

The application for no-fault benefits was dismissed.