Carlos Rippell

The insurer brought a motion to stay the arbitration proceedings because the applicant failed to attend scheduled insurer's medical examinations with a physiatrist and a psychiatrist under section 42 of the Statutory Accident Benefits Schedule.

The arbitrator found that the requested examinations were reasonable and necessary to assess the applicant's ongoing claim for income replacement benefits past the 104-week mark, especially given a newly disclosed potential psychological component.

The applicant failed to provide a reasonable excuse for non-attendance.

The arbitrator ordered that the arbitration be stayed unless the applicant makes herself reasonably available for the examinations.

The applicant, a 66-year-old pedestrian, was struck by a motor vehicle and suffered a fractured leg.

She applied for statutory accident benefits, including non-earner, attendant care, and housekeeping benefits.

The insurer denied the non-earner benefits and disputed the quantum of the other benefits.

The arbitrator found that the applicant suffered a complete inability to carry on a normal life and awarded non-earner benefits.

The arbitrator also awarded increased attendant care and housekeeping benefits, finding the applicant was substantially unable to perform her pre-accident activities.

Furthermore, the arbitrator ordered the insurer to pay a $6,000 special award because it unreasonably delayed the payment of attendant care and housekeeping benefits and unreasonably denied non-earner benefits.