Catherine Korte

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 late insured was involved in a motor vehicle accident while suffering from Stage IV metastatic lung cancer.

He died several months later.

His estate and family members applied for statutory accident benefits, including death benefits, funeral expenses, and the cost of installing a Jacuzzi, arguing that the accident-related injuries interrupted his cancer treatment and contributed to his death.

The arbitrator dismissed the claims, finding based on expert oncological evidence that the accident did not materially contribute to the progression of the cancer or the insured's death, which was inevitable due to the advanced disease.

The arbitrator also found that the stepson was not a dependant and that the Jacuzzi was neither a reasonable nor necessary medical or rehabilitation expense.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic care.

The insurer raised preliminary issues regarding whether all disputed treatment plans from the same clinic should be added to the existing arbitration, and whether the applicant's representatives should be required to provide signed, informed consents from the applicant.

The arbitrator ordered that all disputed treatment plans be added to the arbitration to avoid a multiplicity of proceedings, and required the applicant's representative to provide a signed 'Glinka' acknowledgement.

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.

The insured suffered a foot injury when he was struck by a vehicle while crossing a highway while impaired by alcohol.

Over a month later, he was found dead in an apartment, having bled to death from scalp lacerations sustained in a fall.

His spouse and daughters applied for statutory accident death and funeral benefits, arguing that his foot injury caused the fatal fall.

The arbitrator dismissed the application, finding that the insured fell because he was impaired by alcohol and that his foot injury did not materially or significantly contribute to his fall or death.

The arbitrator also determined that the insured's two daughters qualified as dependants under the Statutory Accident Benefits Schedule.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer denied benefits on the basis that the applicant was operating an uninsured vehicle and had made a material misrepresentation.

The arbitrator found that the applicant deliberately misled his insurance broker by producing ownership documentation for a 1983 vehicle while claiming to insure a 1988 vehicle that he did not own.

The arbitrator concluded that the applicant knew or ought reasonably to have known that he was operating an uninsured vehicle at the time of the accident.

As a result, the applicant was barred from recovering benefits under section 30(1) of the Statutory Accident Benefits Schedule.