Dr. Ernest J. White

The parties cross-appealed an arbitration decision regarding weekly income benefits and arbitration expenses following a motor vehicle accident.

The insured appealed the denial of weekly income benefits after September 5, 1994, and the refusal to adjourn the hearing to cross-examine the insurer's medical expert.

The insurer appealed the order requiring it to pay the insured's arbitration expenses, arguing that November 1996 amendments to the Insurance Act should have been applied.

The Director's Delegate dismissed both appeals, finding that the arbitrator's conclusions on benefits were supported by the evidence, the refusal to adjourn was a reasonable exercise of authority, and the new expense provisions did not apply retroactively to proceedings commenced before the amendments.

The insured was awarded $250 in appeal expenses for responding to the insurer's appeal.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them.

The applicant sought arbitration for ongoing weekly income benefits, claiming an inability to perform his pre-accident duties as a health care aide due to back pain.

The arbitrator reviewed medical evidence and the physical demands of the occupation, concluding that the applicant did not suffer a substantial inability to perform the essential tasks of his employment.

The claim for ongoing weekly income benefits was dismissed, though the applicant was awarded arbitration expenses.

The applicant sought ongoing weekly income benefits and a special award following a motor vehicle accident.

The insurer terminated benefits after an independent medical examination concluded the applicant's complaints were not genuine and he was fit to return to work.

The arbitrator dismissed the claim for ongoing benefits, finding the applicant's evidence lacked credibility due to his active concealment of a prior similar accident and exaggeration of his symptoms.

The claim for a special award was also dismissed, but the applicant was awarded his arbitration expenses because the claim was not manifestly frivolous.

The applicant was injured on a transit bus and received weekly income benefits until they were terminated.

She applied for arbitration to reinstate the benefits, claiming a substantial inability to perform the essential tasks of her employment as a ceramic factory worker.

The arbitrator found the applicant's testimony regarding her pain and inability to work lacked credibility, preferring the objective medical evidence of orthopaedic specialists and surveillance footage showing her performing physical tasks without apparent difficulty.

The application for further weekly income benefits was dismissed, though the applicant was awarded her arbitration expenses.

The applicant sought continued weekly income benefits following a motor vehicle accident.

The insurer had terminated benefits and claimed an overpayment, arguing the applicant was no longer substantially disabled and had received collateral income.

The applicant failed to attend the arbitration hearing or provide required documentation.

Relying on the insurer's medical evidence and the applicant's lack of proof, the arbitrator determined the correct weekly benefit amount, upheld the termination of benefits, and ordered the applicant to repay $26,088.76 in overpaid benefits.