Catherine Korte

The applicant sought statutory accident benefits following a motor vehicle accident.

After the applicant repeatedly failed to attend scheduled Examinations Under Oath and ceased communicating with his legal representative, the representative brought a motion to withdraw from the record.

The insurer brought a motion to dismiss the arbitration and sought costs.

The arbitrator granted the representative's motion to withdraw, dismissed the arbitration on the basis that the applicant had abandoned his claims, and ordered the applicant to pay $5,000 in costs to the insurer.

The insurer, having been entirely successful on the claimant's appeal of an arbitration decision denying further statutory accident benefits, requested an appeal expenses hearing.

The claimant's representative engaged in inappropriate communications regarding settlement discussions and failed to provide responding submissions, citing an unrelated court action.

The Director's Delegate found the insurer entitled to its reasonable appeal expenses based on its degree of success.

The insurer was awarded $5,000 inclusive of disbursements and HST, reflecting the extra time required due to the challenging conduct of the claimant and her representative.

The defendants brought a motion to dismiss the self-represented plaintiff's Statement of Claim under Rule 21.01 or Rule 2.1.

The plaintiff alleged that she reached a settlement agreement for accident benefits with the defendant insurer and three of its employees prior to an arbitration decision that ultimately dismissed her claim.

The court granted the motion in part, dismissing the action against the individual employees as they were acting in the course of their employment and no cause of action was pleaded against them personally.

However, the court declined to dismiss the action against the insurer as frivolous or an abuse of process, finding that the claim for breach of a purported settlement agreement was a distinct cause of action that required evidence to resolve.

The plaintiffs were injured in motor vehicle accidents and sought statutory accident benefits from their insurers.

After disputes arose, the plaintiffs applied to the Financial Services Commission of Ontario (FSCO) for mediation.

When 60 days passed without a mediator being appointed, the plaintiffs commenced civil actions.

The insurers moved to strike or stay the actions, arguing that under s. 281(2) of the Insurance Act, mediation must actually be attempted and fail before an action can be brought.

The Court of Appeal dismissed the insurers' appeals, holding that the 60-day time limit in the legislation is mandatory, and mediation is deemed to have failed if not concluded within that period, freeing the insured to commence a court action.

The court determined costs arising from four similar insurance motions brought by separate defendants in related actions.

The plaintiffs sought partial indemnity costs of $36,500.

The court found that a deduction was required because some counsel time related to unargued Charter applications rather than the motions themselves.

Applying the principles from Hunt v. TD Securities Inc., the court declined to award substantial indemnity costs and instead reduced the requested amount by $8,000.

The plaintiffs were awarded $28,500 plus HST, payable equally among the defendants.

The plaintiff brought a motion under Rule 6.01 of the Rules of Civil Procedure seeking an order that an accident benefits action be tried together with a related tort action arising from the same motor vehicle accident.

The court considered whether the proceedings shared common questions of law or fact and whether trying them together would promote efficiency and avoid inconsistent findings.

Applying factors relating to expediency, convenience, potential prejudice, and overlap of witnesses and expert evidence, the court found that the actions arose from the same accident and involved overlapping issues regarding injuries and damages.

The court concluded that hearing the matters together would reduce duplication of witnesses and trial time without causing meaningful prejudice.

The motion was granted and the actions were ordered to be tried together.

The plaintiffs, injured in motor vehicle accidents, applied for mediation through the Financial Services Commission of Ontario regarding entitlement to statutory accident benefits.

Mediation was not scheduled within 60 days of filing their applications, and the regulator refused to issue reports declaring mediation had failed, asserting the 60‑day period began only once a mediator was appointed.

The plaintiffs commenced court actions and the insurers moved to strike the claims for lack of jurisdiction.

The court held that Rule 19 of the Dispute Resolution Practice Code imposes a mandatory requirement that mediation be concluded within 60 days of filing the mediation application.

Because that period had expired, mediation was deemed to have failed and the plaintiffs were not required to obtain a failed mediation report or pursue internal appeals or judicial review before commencing their actions.

The appellant appealed an arbitrator's decision dismissing his claims for income replacement benefits, housekeeping expenses, and medical and rehabilitation expenses following a 1997 motor vehicle accident.

The appellant argued that the insurer's failure to provide proper notice under sections 37 and 49 of the Schedule entitled him to automatic reinstatement of benefits, and that the arbitrator made numerous errors of fact and law, including ignoring medical evidence and demonstrating bias.

The Director's Delegate dismissed the appeal, holding that inadequate notice does not automatically entitle an insured to benefits, and that the arbitrator's findings of fact regarding the appellant's lack of credibility and failure to meet the disability tests were supported by the evidence.

The Delegate also found no reasonable apprehension of bias and affirmed that appeals under section 283(1) of the Insurance Act are restricted to questions of law.

The applicant was injured in a motor vehicle accident and received income replacement benefits.

The insurer terminated these benefits at the 104-week mark based on a multidisciplinary assessment suggesting the applicant could perform alternative employment.

The applicant sought a special award, arguing the termination was unreasonable.

The arbitrator found that the insurer failed to critically assess the expert reports, which contained significant inconsistencies and ignored the applicant's pre-accident income and limited education.

The insurer's reliance on a flawed assessment process and failure to consider credible evidence to the contrary constituted an unreasonable withholding of benefits.

A special award of 40% of the withheld benefits was ordered.

The claimant was injured in a motor vehicle accident and sought statutory accident benefits.

The insurer raised the preliminary issue of the claimant's mental capacity to proceed with the arbitration.

The arbitrator found that the claimant lacked the mental capacity to proceed in the dispute resolution process, relying on psychiatric evidence of severe attention deficit disorder and the claimant's demonstrated inability to understand the proceedings.

The arbitrator declared the claimant a party under disability and directed the matter to the Public Guardian and Trustee.

The appellant, who was injured in a motor vehicle accident, appealed an interim production order made by an arbitrator at a pre-hearing.

The arbitrator had ordered the appellant to sign authorizations permitting the respondent insurer to obtain various documents, including pre-accident medical records.

The Director's Delegate rejected the appeal, finding that it was from an interim order that did not finally decide the issues in dispute, raised no novel issues, and lacked apparent strength.

The applicant was injured in a motor vehicle accident and applied for income replacement benefits (IRBs) more than two years after the insurer's initial denial.

The applicant argued she was entitled to IRBs based on a business plan for a catering business prepared before the accident.

The arbitrator held that the application was time-barred under section 51(1) of the Statutory Accident Benefits Schedule.

Furthermore, the arbitrator found that even if the application was timely, the applicant did not meet the requirements of section 4(3)1 because a business plan does not constitute a legitimate contract of employment to start work within one year.

The insurer brought a motion to compel the applicant to attend a neurological assessment under section 42 of the Statutory Accident Benefits Schedule to determine ongoing entitlement to income replacement benefits.

The applicant refused, arguing the assessment was sought to buttress the insurer's case for an upcoming arbitration rather than to assess benefit entitlement.

The arbitrator found the assessment was authorized, noting the applicant's head injury and the lack of a prior neurological assessment by the insurer.

The issue of remedy for non-attendance was deemed premature.

The applicant sought statutory accident benefits following a motor vehicle accident.

During the pre-hearing process, the arbitrator raised concerns regarding the competence and conduct of the applicant's non-lawyer representatives.

The representatives failed to comply with multiple directions, including providing a signed acknowledgment regarding their status and the applicant's potential liability for expenses.

The arbitrator found that the representatives were not competent, failed to comply with their duties, and were impeding the applicant's access to justice.

Pursuant to section 23(3) of the Statutory Powers Procedure Act, the representatives were excluded from the proceeding.

The insurer was awarded $1,632.99 in expenses, payable as a setoff against any future award to the applicant regarding the disputed treatment plans.