Dr. John Halpenny

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 appellant appealed an arbitration decision denying his claim for weekly income benefits following a motor vehicle accident.

The appellant argued the arbitrator failed to give proper weight to evidence of a flare-up of back problems and a bulging disc.

The Director's Delegate dismissed the appeal, finding that the arbitrator properly weighed the evidence, preferring the uniform opinions of several orthopaedic specialists over the appellant's general practitioner.

The arbitrator's conclusion that the appellant was not substantially unable to perform the essential tasks of his pre-accident work was supported by the evidence.

No appeal expenses were awarded.

The applicant was struck by a car and claimed statutory accident benefits.

He sought weekly income benefits under section 12 of the Schedule, claiming he was self-employed as a tailor.

The arbitrator found the applicant failed to prove he was employed or self-employed at the time of the accident, as he had declared no income and admitted to avoiding work.

The applicant alternatively claimed ongoing non-earner benefits under section 13.

Relying on consistent specialist medical evidence that the applicant had recovered and was exaggerating his symptoms, the arbitrator concluded the applicant did not suffer a substantial inability to perform his essential tasks.

The claims for ongoing benefits were dismissed, but the applicant was awarded his arbitration expenses.

The applicant, a taxi driver, was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them, alleging overpayment based on fraudulent income records.

The arbitrator found that the applicant remained substantially unable to perform the essential tasks of her employment and was therefore entitled to ongoing weekly income benefits.

However, the arbitrator accepted the insurer's accounting evidence that the applicant's pre-accident financial records were not genuine.

Consequently, her benefits were reduced to the statutory minimum of $185.60 per week, and she was ordered to repay the overpayment to the insurer pursuant to section 27 of the Schedule.