Darrell P. March

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

At the scheduled arbitration hearing, the applicant's paralegal representative renewed a previously denied request for an adjournment, citing the unavailability of medical witnesses and incomplete file disclosure.

The arbitrator denied the adjournment, finding that the representative had failed to properly prepare for the hearing, summons witnesses, or secure medical reports in a timely manner.

As the applicant presented no evidence to meet her burden of proof, all claims for benefits were dismissed, and the insurer was awarded its expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer, including caregiver, housekeeping, and medical benefits.

The insurer terminated caregiver and housekeeping benefits after an occupational therapy in-home assessment.

The arbitrator found that the applicant was not substantially unable to perform her pre-accident caregiving activities, as she could still perform the essential tasks, and denied caregiver benefits.

The claim for medical benefits was denied for lack of evidence.

However, the arbitrator found the applicant was substantially unable to perform some of her pre-accident housekeeping tasks due to pain, and awarded housekeeping benefits at a reduced rate of $50 per week.

Each party was ordered to bear their own arbitration expenses.

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

The insurer denied the claims and provided stoppage notices.

The applicant filed for arbitration more than four years after the initial denial, well beyond the two-year limitation period under the Insurance Act and the Statutory Accident Benefits Schedule.

The applicant argued that his former solicitor was negligent and failed to inform him of the time limits, and that the insurer's notices were defective because they lacked signatures.

The arbitrator held that the applicant is bound by the actions of his agent (solicitor) and that the absence of a signature on the mandatory forms did not invalidate them.

The arbitration was dismissed as time-barred.

The Appellant appealed an Arbitrator's decision dismissing his claim for income replacement benefits (IRBs) beyond 104 weeks following three motor vehicle accidents.

The Arbitrator had found that the Appellant failed to prove he was unable to return to his pre-accident employment under the 'own occupation' test, and consequently failed the more onerous 'any occupation' test.

On appeal, the Director's Delegate held that the Arbitrator made no error of law, as the Arbitrator's preference for the insurer's medical evidence over the Appellant's experts was a non-appealable finding of fact.

The appeal was dismissed.

The appellant insurer appealed an order requiring it to pay interest at the rate provided for by s. 46(2) of the Statutory Accident Benefits Schedule on a sum payable to the respondent insured but unpaid for 19 months.

The Court of Appeal dismissed the appeal, holding that the clear policy intent of s. 46 is compensatory, and it was entirely consistent with that policy to calculate the loss incurred due to the late payment pursuant to s. 46(2).

The applicant sought statutory accident benefits from the insurer following a motor vehicle accident.

At the outset of the arbitration hearing, the insurer raised procedural objections regarding the applicant's late service of the arbitration brief and failure to identify witnesses in accordance with the Dispute Resolution Practice Code.

The arbitrator waived the time requirements for the brief but excluded a witness the applicant intended to call due to lack of notice.

Following these rulings, the applicant's counsel requested to be removed from the record, and the applicant sought an adjournment to retain new counsel.

The arbitrator granted the removal of counsel and the adjournment, ordering the insurer entitled to its costs thrown away for the morning of the hearing.

The applicant sought statutory accident benefits for caregiving, housekeeping, and medical expenses following a motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant's evidence regarding her inability to perform caregiving and housekeeping tasks to be inconsistent, contradictory, and lacking credibility.

Surveillance evidence showed the applicant performing tasks she claimed to be unable to do.

The arbitrator preferred the medical evidence of the insurer's assessors over the applicant's practitioners.

The claim for medical benefits was also dismissed as the applicant admitted she did not receive the recommended chiropractic treatments, and further massage therapy was deemed not reasonable or necessary.

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

A dispute arose regarding the application of indexation provisions under section 79 of the Statutory Accident Benefits Schedule to the calculation of her loss of earning capacity (LEC) benefit.

The arbitrator determined that, unlike income replacement benefits, the indexation of the net weekly income used to determine the LEC is not limited by section 79(2).

Therefore, the applicant's net weekly income used to determine her pre-accident earning capacity is to be indexed every year starting January 1, 1995.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, housekeeping expenses, medical benefits, and costs of examinations.

The insurer terminated benefits, and the applicant applied for arbitration.

The arbitrator found that the applicant did not suffer a substantial inability to perform the essential tasks of her employment, noting she felt well enough to try working.

Claims for housekeeping were dismissed due to lack of persuasive evidence.

Medical benefits for chiropractic treatment were denied as the treatment was not justified, reasonable, or necessary.

Claims for assessment costs were also dismissed as the reports were not reasonably required.

The application was dismissed in its entirety.

The applicant was involved in three motor vehicle accidents in 2001 and sought income replacement benefits beyond October 6, 2002, claiming he was unable to return to his pre-accident job due to chronic pain and psychological problems.

The insurer terminated benefits based on multiple disability assessments concluding he was capable of working.

The arbitrator found that while the accidents contributed to his complaints, the applicant failed to prove he suffered a substantial inability to perform the essential tasks of his pre-accident employment.

The arbitrator preferred the evidence of the disability assessors over the applicant's treating physicians and experts, noting weaknesses in the latter's opinions and the fact that the applicant had successfully held other jobs post-accident.

The application for ongoing benefits and a special award was dismissed.

The parties sought their respective expenses following an arbitration decision that dismissed the applicant's claim for statutory accident benefits.

The insurer argued it was wholly successful and entitled to expenses.

The applicant argued the insurer's representative unnecessarily prolonged and obstructed the hearing.

The arbitrator found that the insurer's representative's conduct, including unnecessary preliminary objections and repetitive cross-examinations, unnecessarily prolonged a simple one-day hearing into three days.

Consequently, the insurer was denied its expenses.

The applicant was also denied his expenses because his underlying claim failed due to his lack of credibility and significant contradictions with his medical records.

Each party was ordered to bear its own expenses.

The applicants, a husband and wife, sought statutory accident benefits for caregiving, housekeeping, and medical treatment following a motor vehicle accident.

The insurer denied the claims.

At arbitration, the applicants argued they were unable to perform their pre-accident caregiving and housekeeping duties and required ongoing medical treatment.

The arbitrator found the applicants' evidence to be contradictory and implausible, noting they both continued to work and even studied for new careers while claiming to be completely disabled from household tasks.

The arbitrator also drew an adverse inference from their failure to call their alleged service provider as a witness.

The claims for caregiving, housekeeping, medical benefits, and interest were dismissed.

In a pre-hearing for a statutory accident benefits dispute, the applicant sought an order compelling the insurer to produce an affidavit of documents for its file subsequent to mediation.

The insurer sought an order compelling the applicant to disclose whether a tort claim had been initiated.

The arbitrator dismissed the applicant's request, finding no evidence to justify ordering an affidavit of documents and noting that documents created post-mediation are highly likely to be protected by litigation privilege.

The arbitrator granted the insurer's request, ordering the applicant to provide a written answer regarding the existence of a tort claim, as such information is relevant to the arbitration.

The Applicant was injured in a motor vehicle accident and claimed statutory accident benefits for caregiver and housekeeping expenses.

The Insurer paid portions of the claims but denied others based on in-home assessments and insurer examinations.

The Arbitrator reviewed the medical evidence, including reports from occupational therapists and physiatrists, and found the Applicant was entitled to an additional $310.00 for caregiver benefits and $42.50 for housekeeping expenses for specific periods where the Insurer unreasonably denied or miscalculated the benefits.

Claims for periods after October 2005 were dismissed as the evidence showed the Applicant had regained independence in her activities of daily living.

The applicant was involved in two motor vehicle accidents in 2002 and sought statutory accident benefits, including income replacement, medical, and housekeeping benefits.

The insurer denied the claims, arguing a lack of causation for symptoms that arose six months after the second accident.

The arbitrator found that while the applicant was substantially unable to perform his pre-accident employment duties after March 2003, he failed to establish on a balance of probabilities that either accident caused the delayed onset of his significant symptoms.

Consequently, the claims for income replacement benefits and further chiropractic treatment for the second accident were dismissed.

The arbitrator did award outstanding chiropractic expenses for the first accident and a small balance for housekeeping services, along with interest on the overdue amounts.

The applicant was involved in two motor vehicle accidents in 2002 and sought statutory accident benefits, including income replacement, medical, and housekeeping benefits.

The insurer denied the claims, arguing that the applicant's significant symptoms, which began in March 2003, were not causally related to the accidents due to a five-month gap in symptoms and medical treatment.

The arbitrator agreed, finding that the applicant failed to establish causation on a balance of probabilities, and dismissed the claim for income replacement benefits and further medical benefits for the second accident.

However, the arbitrator awarded $2,142 for chiropractic expenses related to the first accident and an additional $30 for housekeeping services, along with interest on the overdue amounts.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including medical, caregiver, and housekeeping benefits.

The insurer denied certain treatment plans and terminated the weekly benefits.

The arbitrator found that the chiropractic treatment incurred up to June 30, 2005, was reasonable and necessary, awarding $2,509.00 for medical benefits.

However, the claims for caregiver and housekeeping benefits were dismissed, as the applicant was not the primary caregiver and any substantial inability to perform housekeeping tasks had resolved prior to the termination of benefits.

The applicants, a mother and daughter, were injured in a motor vehicle accident and sought statutory accident benefits from their insurer.

The insurer denied further medical treatment, housekeeping benefits, and the cost of in-home assessments.

The arbitrator found that the insurer's procedural breaches in denying the treatment plans did not automatically entitle the applicants to the benefits.

The arbitrator denied the majority of the claimed medical benefits, preferring the opinions of the Designated Assessment Centres that further facility-based passive treatment was not reasonable and necessary.

The daughter was awarded a small amount for a home exercise program and an unpaid balance of an uncontradicted treatment plan.

The mother was awarded housekeeping benefits at a reduced rate for a limited period, but the daughter's housekeeping claim was denied due to lack of evidence that she performed such duties pre-accident.

The claims for in-home assessments were denied as they were conducted at a residence where the applicants did not live at the time.

The applicant sought statutory accident benefits, including caregiver, housekeeping, and medical benefits, following a motor vehicle accident.

The insurer denied the claims, arguing the applicant's injuries, particularly to her wrist, were pre-existing from a prior accident.

The arbitrator dismissed the applicant's claims, finding insufficient evidence that the second accident caused or exacerbated her wrist problems, and preferring the independent medical assessments which concluded she was not disabled from caregiving or housekeeping.

The applicants were injured in a motor vehicle accident and sought statutory accident benefits from the insurer.

The insurer denied certain medical benefits and housekeeping expenses, and sought repayment of income replacement benefits paid to the applicant after he returned to work.

The arbitrator found that both applicants were entitled to the claimed medical benefits for treatment, as the injuries went beyond minor soft tissue injuries and the treatment was reasonable and necessary.

The applicant was ordered to repay a portion of the income replacement benefits he received while working.

The claim for housekeeping expenses was dismissed due to insufficient evidence.

Interest was awarded on overdue payments.