Cara Boddy

The appellant insurer appealed an arbitrator’s decision that snow plow vehicles involved in a motor vehicle accident were “commercial vehicles” under Ontario Regulation 664 and therefore subject to the statutory loss transfer regime under the Insurance Act.

The appellant argued the definition required that a vehicle first be used primarily to transport goods, tools, or equipment before falling within the enumerated list following the phrase “and includes.” The court held that the enumerated list broadens the definition and captures vehicles such as those designed for construction or maintenance purposes even if they are not primarily used for transporting materials.

Applying a contextual and purposive approach to statutory interpretation, the court found the arbitrator correctly interpreted the regulation.

The appeal was dismissed and the arbitrator’s conclusion that the snow plows were heavy commercial vehicles subject to loss transfer was upheld.

The Applicant was injured in a motor vehicle accident and applied for a determination of catastrophic impairment.

The parties agreed on a 34% physical whole person impairment but disputed the mental and behavioural impairment rating.

The arbitrator preferred the evidence of the Applicant's psychological expert, finding that the Applicant suffered a marked impairment in adaptation to work environments due to severe panic disorder and agoraphobia.

The arbitrator concluded that the Applicant sustained a catastrophic impairment under both clause 2(1.2)(g) (marked mental impairment) and clause 2(1.2)(f) (combined physical and mental impairment of 60%).

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits for massage therapy, chiropractic care, and a magnetic resonance stimulation machine (MRS 2000).

The Insurer denied the claims.

The Arbitrator found the Applicant to be highly credible and motivated, and concluded that the massage therapy and chiropractic care were reasonable and necessary to support her active rehabilitation and pain management goals.

The claim for the MRS 2000 was dismissed as its cost was not reasonable given the minor degree of success and lack of supporting evidence.

Interest was awarded on the overdue benefits.

The insurer sought its expenses following a successful preliminary issue hearing where the applicant's claim for income replacement benefits was found to be statute-barred.

The arbitrator determined that the insurer was entitled to its expenses, as it was entirely successful and the applicant did not raise any novel issues.

The arbitrator awarded the insurer $2,627.86 in expenses, adjusting the claimed hourly rates to align with the Legal Aid Services Act and denying the disbursement for a court reporter.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until they were terminated by the insurer.

More than two years after the termination, the applicant sought reinstatement of IRBs, arguing that her condition had deteriorated.

The insurer denied the request on the basis that the claim was statute-barred.

The arbitrator held that the applicant could not avoid the limitation period by submitting a new request for IRBs based on a subsequent deterioration in her condition.

The claim was found to be statute-barred under section 281.1 of the Insurance Act and section 51 of the Schedule.

The appellant was injured in a motor vehicle accident in the course of his employment.

He claimed and received statutory accident benefits but did not claim workers' compensation benefits.

After his accident benefits were terminated, he commenced a tort action just days before an arbitration pre-hearing.

The arbitrator found that the appellant's election to bring a tort action was made primarily for the purpose of claiming accident benefits, precluding him from relying on the exception in subsection 59(2) of the SABS-1996.

The Director's Delegate dismissed the appeal, finding no error in the arbitrator's consideration of the appellant's failure to pursue the tort claim as evidence of his primary purpose.

Following a successful arbitration where the applicant's claims for statutory accident benefits were dismissed, the insurer sought its expenses.

The arbitrator found that the insurer was entirely successful and therefore entitled to expenses under section 12(2) of O. Reg. 664/90.

The arbitrator adjusted the claimed hourly rate to the maximum permitted under the Legal Aid Services Act, 1998, awarding the insurer $4,067.36 in fees and disbursements.

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

She had been injured in a prior accident seven months earlier, which had prevented her from performing these activities at the time of the second accident.

The arbitrator held that entitlement to these benefits is based on the activities the insured actually performed at the time of the accident, not on a retained status.

Because the applicant was not the primary caregiver and did not normally perform housekeeping activities at the time of the second accident due to impairments from the first, she was not entitled to the claimed benefits.

The application was dismissed.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The applicant failed to appear at the arbitration hearing.

The arbitrator stayed the proceeding to allow the applicant time to provide an explanation, but no correspondence was received and mail sent to the applicant's last known address was returned.

The application was dismissed.

The applicant, who was injured in a motor vehicle accident, applied for statutory accident benefits and subsequently for arbitration.

He failed to appear at the hearing, having sent a letter requesting an adjournment due to alleged family emergencies, but subsequently lost contact with his counsel and the Commission.

The arbitrator refused to grant the adjournment immediately but declined the insurer's request to dismiss the application outright.

Instead, the arbitrator stayed the proceeding and ordered the applicant to provide justification for his absence and pay $750 in expenses to the insurer by a specified date, failing which the application would be dismissed.