Douglas A. Wallace

The applicant, a part-time supply teacher, was injured in a motor vehicle accident and claimed a loss of earning capacity benefit.

The parties disagreed on the method to convert her part-time pre-accident income to full-time income under section 86 of the Statutory Accident Benefits Schedule.

The arbitrator found that the reasonable method for establishing the number of hours in a regular work week for a full-time teacher must take into account the fixed number of school days (194) and the corresponding annual salary.

The arbitrator determined the applicant's gross annual income to be $36,714, rejecting the applicant's argument for a higher amount based on her personal and vocational characteristics.

The insurer appealed an arbitration decision reinstating the insured's income replacement benefits, arguing the Arbitrator failed to apply the 'crumbling skull' rule to the insured's pre-existing heart condition.

The Director's Delegate dismissed the appeal, finding the Arbitrator correctly applied the 'significant or material contribution' test from Athey v. Leonati.

The Arbitrator's factual finding that the insured's heart condition did not deteriorate significantly after the accident and did not impact his functional ability was supported by the evidence and not reviewable as an error of law.

The applicant was seriously injured in a motor vehicle accident and sought payment for services provided by a rehabilitation consultant.

The insurer denied payment, arguing the services were case management, which are only compensable if the insured suffered a catastrophic impairment.

The arbitrator found that the statutory definition of 'case manager' is exhaustive and limited to coordinating medical, rehabilitation, or attendant care benefits.

Services coordinating other benefits, such as caregiver or housekeeping benefits, are not case management and may be compensable as rehabilitation benefits under section 15.

The arbitrator concluded that some of the consultant's services were case management and not compensable, while others were rehabilitation services and potentially compensable.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on a disability assessment.

The applicant sought ongoing benefits, arguing that accident-related headaches, neck, and back pain prevented him from working full-time as a travel agent.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment due to chronic pain from soft-tissue injuries and aggravated pre-existing conditions.

The arbitrator ordered the insurer to pay ongoing income replacement benefits but denied the applicant's claim for a special award, finding the insurer's termination of benefits was not unreasonable.

The insured sought a declaration that a full and final release was null and void due to lack of capacity, undue influence, and the insurer's failure to comply with statutory notice requirements.

The motion judge dealt with the capacity and undue influence issues on a Rule 21 motion, which the Court of Appeal found was an error as those issues depended on disputed facts.

However, on the cross-appeal, the insurer conceded based on recent jurisprudence that its failure to comply with the statutory requirements rendered the release null and void.

The cross-appeal was allowed and the appeal was dismissed as moot.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them.

She applied for arbitration seeking ongoing IRBs, housekeeping expenses, and a special award.

The arbitrator found that the applicant suffered from physical and psychological impairments, including post-traumatic stress disorder and chronic pain, caused by the accident.

The arbitrator concluded that she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a fabric cutter and awarded ongoing IRBs.

Housekeeping expenses were partially awarded for the initial period following the accident.

The claim for a special award was dismissed, and the issue of repayment was deferred.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits from the insurer.

The insurer denied further benefits and discouraged the applicant from applying, without explicitly requesting a treatment plan.

The insurer later raised the applicant's failure to submit a treatment plan as a preliminary issue at mediation.

The arbitrator held that the applicant failed to submit a valid treatment plan.

However, because the insurer breached its statutory duty to assist the applicant by failing to promptly advise her that a treatment plan was required, the applicant was permitted to proceed to arbitration for expenses incurred before the mediation date.

The applicant was barred from proceeding for expenses incurred between the mediation date and the hearing date, as she was aware of the requirement by that time.

The Applicant was injured in a motor vehicle accident and received income replacement benefits until they were terminated by the Insurer.

The Applicant sought reinstatement of benefits for a closed period, while the Insurer sought payment of a cancellation fee for a missed psychological assessment.

The Arbitrator found that the Applicant failed to provide cogent medical evidence to prove a substantial inability to perform the essential tasks of his employment, relying instead on a multidisciplinary assessment that concluded he was not disabled.

The Arbitrator also dismissed the Insurer's claim for the cancellation fee, finding that the Applicant was not given sufficient notice of the appointment to comply with the cancellation policy.

The arbitration was dismissed.

The respondent, an 80-year-old woman, slipped and fell on an icy municipal sidewalk after disembarking from a city transit bus.

She sued the appellant city in both negligence and breach of contract.

The trial judge found the negligence claims statute-barred but allowed the contract claim, holding that section 266 of the Insurance Act did not preclude it.

On appeal, the Divisional Court held that while section 266 does not automatically foreclose genuine actions in contract where a motor vehicle is merely incidental, the respondent's claim was essentially a disguised negligence claim.

As there was no independent contractual obligation imposing liability, the action was statute-barred and the appeal was allowed.

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

A dispute arose regarding the calculation of her gross income for income replacement benefits.

The Applicant was both employed and self-employed in the four weeks preceding the accident.

The arbitrator held that under section 8(2) of the Statutory Accident Benefits Schedule, because the Applicant was self-employed at any time during the four weeks before the accident, she must designate either the 52 weeks before the accident or the last fiscal year of her business to calculate her gross income.

The Applicant was awarded her reasonable expenses of the arbitration.

The Vanier Police Services Board applied to the Ontario Civilian Commission on Police Services for a ruling that court security costs should not be included in the cost-sharing formula under its policing agreement with the Ottawa Police Services Board, and for repayment of past amounts.

The Commission found it had jurisdiction to interpret the agreement but not to order repayment.

On the merits, the Commission ruled that the broad definition of operating costs in the agreement included the newly imposed statutory costs of providing court security.