Christopher J. Schnarr

Following a preliminary issue hearing where the insurer successfully argued the applicant was not an insured person, the applicant sought her arbitration expenses.

The arbitrator found that the application was brought in good faith on a novel and significant issue of interpretation, which outweighed the insurer's ultimate success.

The applicant was awarded expenses fixed at $9,197.93, with deductions made for certain pre-arbitration fees, an unnecessary airline ticket for the applicant's mother, and unallowable travel disbursements.

The applicant, a Mexican citizen studying English in Toronto, was injured in a motor vehicle accident in Quebec while a passenger in a vehicle insured by the respondent.

She applied for statutory accident benefits in Ontario.

The insurer denied the claim on the basis that she was not a 'resident of Ontario' and therefore not an 'insured person' under section 2 of the Bill 59 Schedule.

The arbitrator found that the applicant's stay in Ontario was temporary and for a limited purpose, lacking the permanence required to establish residency.

The applicant was found not to be an insured person under the Schedule.

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

A dispute arose regarding the calculation of his weekly income replacement benefits, as he held two jobs prior to the accident but could only continue one post-accident.

The applicant brought a motion for interim benefits pending the final arbitration.

The arbitrator found that the applicant presented prima facie evidence of his self-employment as a cleaner at the time of the accident and his inability to continue this work due to his injuries.

The arbitrator also accepted the applicant's evidence of financial urgency.

The insurer was ordered to pay interim income replacement benefits based on the lost cleaning income, without deduction for deemed employment income that was no longer available.

The applicant, a minor whose mother was killed in a motor vehicle accident, sought statutory accident benefits for care expenses.

The insurer denied the claim on the basis that the applicant had not suffered an impairment.

On a preliminary issue hearing, the arbitrator held that under the Statutory Accident Benefits Schedule, an impairment is a strict prerequisite for care benefits, and the death of a parent does not in itself constitute an impairment as a matter of law.

However, the arbitrator noted that the loss of a parent could factually result in a psychological impairment entitling the child to benefits.

The applicants were injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated the wife's income replacement benefits and denied the husband's non-earner benefits.

The insurer brought a motion requesting that the applicants attend an insurer's examination with an orthopaedic specialist.

The arbitrator found the request reasonable, noting that the applicants had not been assessed by the insurer's experts in three years and new medical information had recently been provided by the applicants' treating practitioners.

The appellant was injured in a motor vehicle accident and claimed income replacement benefits.

The insurer terminated benefits based on medical assessments indicating the appellant could return to work.

The arbitrator dismissed the appellant's claim for ongoing benefits, finding he was not substantially unable to perform the essential tasks of his self-employment in construction, and calculated a reduced benefit rate based on estimated business expenses.

On appeal, the Director's Delegate upheld the arbitrator's decision, finding no error in the assessment of the expert medical evidence or the pragmatic calculation of the appellant's self-employment income.

The insurer brought a motion for interim expenses against the applicant due to the conduct of the applicant's counsel.

The applicant's counsel failed to attend a scheduled pre-hearing discussion without a reasonable excuse and failed to comply with undertakings to produce medical authorizations and an OHIP summary within the required timelines.

The arbitrator found that the counsel's conduct prejudiced the insurer and frustrated the Commission's mandate to facilitate settlement.

The arbitrator ordered the applicant to pay $300 in interim expenses to the insurer, noting that the award should ideally be paid personally by the counsel.

The applicant sought weekly income replacement benefits following a motor vehicle accident but failed to attend the arbitration hearing or comply with production orders.

The arbitrator dismissed the claim for benefits due to a lack of evidence.

The insurer sought an award under section 282(11.2) of the Insurance Act, arguing the arbitration was frivolous and vexatious.

The arbitrator dismissed this request, finding the claim was not devoid of merit when commenced.

However, the arbitrator awarded the insurer its expenses of the proceeding, concluding that the applicant's repeated failures to comply with orders and attend hearings constituted an abuse of process that unreasonably prolonged the matter.

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

The insurer terminated benefits and the applicant applied for arbitration.

The insurer argued the application was barred by the two-year limitation period under subsection 281(5) of the Insurance Act.

The applicant's representative claimed to have filed two previous applications within the limitation period that were allegedly misplaced by the Commission.

The arbitrator rejected the representative's evidence as fabricated and unreliable, finding the application was filed out of time.

The arbitration was dismissed, and the applicant was ordered to pay $1,000 of the insurer's expenses due to the manifestly unfounded claims regarding the limitation period.

The Applicant was injured in a motor vehicle accident and claimed statutory accident benefits, including income replacement benefits as a self-employed construction worker.

The Insurer paid some benefits but terminated them on March 11, 1996.

The Arbitrator found that the Applicant did not suffer a substantial inability to perform the essential tasks of his employment or a partial/complete inability to carry on a normal life after March 11, 1996.

However, the Arbitrator determined the correct quantum of benefits prior to termination, allowing the Applicant to extrapolate his income under subsection 9(3) of the Schedule.

The Arbitrator also granted a $500 special award because the Insurer unreasonably withheld minimum benefits prior to termination, and awarded the Applicant his expenses of the arbitration.

The applicants were injured in a motor vehicle accident and claimed statutory accident benefits from the insurer, including income replacement benefits, caregiver benefits, and taxi expenses.

The arbitrator found that the insurer was liable to pay benefits as there was no other available insurance.

However, the arbitrator dismissed the claims for income replacement benefits, finding that neither applicant had a legitimate contract of employment evidenced in writing at the time of the accident, and the female applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident self-employment.

The claims for caregiver benefits and taxi expenses were also dismissed due to a lack of objective medical evidence and failure to prove the expenses were reasonably incurred.

The applicants were awarded one-third of their arbitration expenses.