Alexandra Smol

The insurer appealed arbitration decisions that dismissed its motions to compel the insured to attend insurer examinations and ordered it to pay a special award for unreasonably delaying benefits.

The insured cross-appealed the denial of a special award for other periods of delay.

The Director's Delegate dismissed both appeals.

The Delegate found that the arbitrators did not err in law in refusing the insurer examinations, as the insurer had delayed its requests until after the arbitration process was well underway.

Furthermore, the insurer's concession of entitlement during the hearing precluded a finding that it was denied a fair hearing.

The Delegate upheld the special award, finding no basis to interfere with the arbitrator's assessment of the insurer's unreasonable conduct, and agreed that the insurer's delay while seeking a stay of an interim order was not unreasonable.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for caregiving and housekeeping expenses.

The insurer terminated these benefits based on in-home assessments and independent medical examinations indicating the applicant was not substantially disabled.

The applicant submitted invoices for services allegedly provided by her sister and a neighbour.

The arbitrator found the invoices to be unreliable and fabricated, noting they contradicted the applicant's own statements to assessors and the testimony of the service providers.

The application for benefits and a special award was dismissed, and the insurer was awarded its expenses of the arbitration proceeding.