Aneez Virani

The Applicant was catastrophically injured in a motor vehicle accident and previously awarded statutory accident benefits, including income replacement, attendant care, and nutritional counselling.

In this resumed hearing, the Arbitrator determined the Applicant's entitlement to interest on overdue benefits and a special award.

The Arbitrator found the Insurer liable for interest on all three benefit categories, noting the Insurer had sufficient information to adjust the claims early on despite procedural delays by the Applicant.

Furthermore, the Arbitrator ordered a special award of $750,000 against the Insurer under section 282(10) of the Insurance Act, finding the Insurer's conduct in handling the attendant care and nutritional counselling claims to be significantly blameworthy and in breach of its statutory obligations.

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

The arbitrator found that the insurer's notices terminating income replacement benefits were not clear and unequivocal, meaning the limitation period had not expired.

The arbitrator determined the applicant was an employee rather than self-employed at the time of the accident.

The applicant was awarded 24-hour attendant care benefits retroactive to the accident date due to severe cognitive and behavioural impairments, despite a delay in submitting the formal application.

The arbitrator also awarded housekeeping benefits, nutritional counselling, and medical benefits for the purchase of medical marijuana, finding that marijuana was not an experimental treatment in the specific circumstances of the applicant's brain injury and chronic pain.

The applicant, who suffered a moderate brain injury in a pedestrian motor vehicle collision, sought interim attendant care benefits after the insurer terminated them.

The insurer relied on a Designated Assessment Centre (DAC) report suggesting the applicant's need for supervision pre-dated the accident due to ADHD.

The arbitrator found significant flaws in the DAC report, including procedural irregularities and a failure to consider whether the accident exacerbated pre-existing vulnerabilities.

Finding that the applicant established a compelling prima facie case for entitlement and urgency due to safety risks, the arbitrator ordered the insurer to pay interim attendant care benefits pending a full arbitration hearing.