Darrell P. March

The applicant was struck by a vehicle while crossing a street and sought income replacement benefits (IRBs) and medical benefits from her insurer.

The insurer terminated IRBs and denied further medical benefits.

At arbitration, the applicant claimed physical and psychological impairments, relying on a multi-disciplinary assessment.

The arbitrator rejected the applicant's expert psychological evidence, noting the assessors had little to no contact with the applicant and their conclusions were inconsistent with her failure to seek psychological treatment and her academic achievements post-accident.

Finding no physical or psychological impairments caused by the accident, the arbitrator dismissed the claims for IRBs, medical benefits, and a special award.

The Applicant was injured in a motor vehicle accident in 2013 and sought statutory accident benefits from the Insurer, claiming he suffered a catastrophic impairment.

The Applicant had a history of severe pre-existing psychological and physical impairments from prior accidents in 2002.

The Insurer denied the catastrophic impairment designation and various medical benefits, arguing that any impairment was due to the pre-existing conditions.

The arbitrator found that the 2013 accident materially contributed to the Applicant's psychiatric condition, worsening his impairment to a Class 4 marked impairment in activities of daily living.

The arbitrator concluded the Applicant suffered a catastrophic impairment and awarded the disputed medical benefits and examination costs, finding them reasonable and necessary for pain relief and assessment.

The claim for a special award was dismissed, but the Insurer was ordered to pay the Applicant's arbitration expenses and interest on overdue benefits.

The appellant appealed an Arbitrator's decision dismissing her claims for post-104 week income replacement benefits and a medical benefit for a physiotherapy treatment plan.

The Director's Delegate found that the Arbitrator failed to provide adequate reasons for his decision, which constituted a breach of natural justice and procedural fairness.

The Arbitrator ignored, failed to summarize, analyze, or consider important evidence that was not supportive of the insurer's position, and misinterpreted other evidence.

The appeal was allowed, the decision rescinded, and the matter returned to arbitration for a fresh hearing before a different arbitrator.

Following an arbitration where the insurer was entirely successful in defending against claims for statutory accident benefits, the insurer requested an expense hearing.

The applicant failed to provide written submissions.

The arbitrator considered the criteria under Rule 75.2 of the Dispute Resolution Practice Code and found the insurer's claimed expenses reasonable and in compliance with the Legal Aid Tariff.

The applicant was ordered to pay the insurer's expenses fixed at $22,722.12.

The appellant appealed an arbitrator's decision dismissing her claims for post-104 week income replacement benefits and a medical benefit for a physiotherapy treatment plan.

The Director's Delegate allowed the appeal, finding that the arbitrator failed to provide adequate reasons for his decision and failed to fairly consider the evidence from both parties.

The arbitrator ignored or misinterpreted significant evidence from several experts, including those retained by the insurer, whose opinions supported the appellant's claims.

The matter was returned to arbitration for a fresh hearing before a different arbitrator.

The applicant sought accident benefits following a motor vehicle accident where a garage door closed on his car.

The insurer denied the treatment plans, arguing the applicant's injuries fell under the Minor Injury Guideline (MIG) and were related to pre-existing conditions.

The arbitrator found no compelling evidence that the applicant suffered an impairment directly related to the accident or that his pre-existing chronic pain was exacerbated by it.

The application for medical benefits, cost of examinations, and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits, medical benefits, transportation expenses, an assessment expense, interest, and a special award.

The arbitrator found that credible psychological and orthopedic evidence established chronic pain and related psychological sequelae, taking the claim outside the Minor Injury Guideline and supporting entitlement to the disputed physiotherapy treatment plans.

Applying the Schedule's pre-104-week test, the arbitrator held that the applicant had a substantial inability to perform the essential tasks of his pre-accident employment and was entitled to weekly income replacement benefits for that period only.

The post-104-week claim failed because the evidence did not prove a complete inability to engage in any suitable employment.

Transportation and interest were awarded, the in-home assessment expense and special award were denied, and expenses were left to further determination if necessary.

The three applicants were involved in a motor vehicle accident and sought various statutory accident benefits, including non-earner benefits, attendant care benefits, and medical rehabilitation benefits.

The insurer denied the claims based on independent medical examinations indicating that the applicants' ongoing impairments were related to pre-existing conditions rather than the accident.

The arbitrator found that none of the applicants suffered a complete inability to carry on a normal life, and that the proposed treatment plans and attendant care were neither reasonable nor necessary.

All claims for benefits were dismissed.

The applicant was involved in two motor vehicle accidents and sought statutory accident benefits.

The arbitrator found that the applicant suffered a catastrophic impairment as a result of the second accident, primarily due to psychiatric impairments including major depressive disorder, which resulted in a marked impairment in work adaptation.

The claims for attendant care and housekeeping benefits were dismissed as statute-barred because the applicant failed to provide timely notice and an assessment of attendant care needs prior to mediation.

Various medical and rehabilitation benefits were found to be reasonable and necessary and were awarded.

The claim for a special award was dismissed as the insurer acted reasonably in adjudicating the complex claims.

Following an appeal and cross-appeal regarding statutory accident benefits where both parties enjoyed mixed success, both parties sought their legal expenses of the appeal.

The Director's Delegate found that neither party enjoyed a significantly greater degree of success that would warrant an award of expenses.

The parties were ordered to bear their own expenses of the appeal and cross-appeal.

The applicant's spouse was involved in a minor rear-end motor vehicle accident.

The following day, he committed suicide by overdosing on sleeping pills.

The applicant sought death benefits under the Statutory Accident Benefits Schedule, arguing the suicide was a direct result of the accident.

The arbitrator found no causal nexus between the use or operation of the vehicle and the suicide, concluding the death was not directly caused by the accident.

The claim for death benefits was dismissed.

The applicant was involved in two motor vehicle accidents and filed two separate Applications for Arbitration for non-earner benefits.

The insurer brought a preliminary motion to dismiss the second application as frivolous, vexatious, and an abuse of process, arguing it duplicated the first.

The applicant requested that the two applications be combined.

The arbitrator found no evidence that the second application was an abuse of process, noting that the issue of benefits arising from the first accident had not yet been litigated.

The arbitrator ordered the two applications combined pursuant to Rule 30 of the Dispute Resolution Practice Code to ensure the most just, quickest, and least expensive resolution.

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

At the hearing, the applicant requested to withdraw the claims, but the insurer did not consent.

The applicant did not call any evidence to support his claims.

As the applicant failed to discharge his burden of proof, the arbitrator dismissed the claims in their entirety.

The insurer was awarded $3,500.00 in expenses.

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

The insurer terminated her income replacement benefits and denied medical and rehabilitation benefits, maintaining for nearly three years that her injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the applicant suffered a substantial inability to perform her pre-accident employment and, post-104 weeks, a complete inability to engage in suitable employment due to chronic pain.

The arbitrator granted the claimed income replacement benefits, medical benefits, and costs of examinations.

Furthermore, the arbitrator awarded a $25,000 Special Award against the insurer, finding that it had unreasonably delayed and denied benefits by relying on patently flawed medical reports and ignoring credible evidence of the applicant's chronic pain.

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

The insurer denied the claim for non-earner benefits in November 2011.

More than four years later, the applicant disputed the denial.

The insurer brought a preliminary issue motion to dismiss the claim as statute-barred.

The Licence Appeal Tribunal granted the motion, finding that the two-year limitation period under section 56(1) of the Statutory Accident Benefits Schedule began when the insurer issued a clear and unequivocal refusal in 2011.

The insurer's request for costs was denied as the applicant's conduct was not unreasonable, frivolous, vexatious, or in bad faith.

Both parties appealed an Arbitrator's decision regarding statutory accident benefits following a motor vehicle accident.

The Director's Delegate found that the Arbitrator breached procedural fairness by failing to provide adequate reasons for awarding attendant care, housekeeping, medical/rehabilitation benefits, and the cost of assessments.

The Delegate upheld the Arbitrator's finding that the accident caused the insured's shoulder injury and the award of income replacement benefits, but found no evidentiary basis for limiting the benefits to a three-month post-surgery period.

The Delegate also found the Arbitrator's dismissal of a special award to be self-contradictory given the finding that the insurer unreasonably withheld benefits.

The unsupported and unreasoned portions of the decision were rescinded and remitted for rehearing.

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits, including an Income Replacement Benefit (IRB) beyond the 104-week mark and a Medical Treatment Plan.

The Insurer denied the benefits.

The Arbitrator found that the Applicant did not meet the "complete inability" test required for post-104 week IRBs, noting her history of working in a sedentary position and the availability of suitable alternative employment that would provide a higher income than her pre-accident earnings.

The Arbitrator also dismissed the claim for the Medical Treatment Plan, finding that the Applicant failed to prove it was reasonable and necessary, and did not contradict the Insurer's medical evidence that she had reached maximum therapeutic benefit.

The application was dismissed.

The respondent insurer requested a reconsideration of two cost orders issued by the Tribunal, arguing that the parties had settled their respective disputes before the decisions were issued.

The Tribunal found that the applicants' counsel failed to notify the Tribunal of the settlement and instead simply filed Notices of Withdrawal.

Concluding that it would be unfair for the applicants to benefit from the cost orders given the prior settlement, the Executive Chair granted the reconsideration and cancelled the cost orders.

The applicant sought costs against the respondent insurer for failing to comply with two Tribunal orders for the production of documents.

The Tribunal found that the respondent acted unreasonably by ignoring the orders and the applicant's follow-up communications, which necessitated a second production order and delayed the proceedings.

The Tribunal ordered the respondent to pay $250.00 in costs to the applicant to discourage such conduct.

The applicant sought costs against the respondent insurer for failing to comply with two Tribunal orders for the production of documents.

The respondent did not produce the required documents until after a second order was issued and the applicant had requested costs.

The Tribunal found the respondent's conduct to be unreasonable, as it disregarded the Tribunal's orders and delayed the proceedings.

The Tribunal awarded costs of $250.00 to the applicant to discourage such conduct in the future.