Dr. Joseph Garber

The insured appealed an arbitrator's decision terminating his income replacement benefits (IRBs) based on the post-accident onset of unrelated medical conditions (diabetes, high blood pressure, heart condition).

The Director's Delegate allowed the appeal, finding the arbitrator erred in law by failing to recognize that the motor vehicle accident remained a material cause of the insured's ongoing disability, regardless of the subsequent unrelated conditions.

The insurer's cross-appeal to add wilful misrepresentation as an issue was dismissed for failure to provide proper statutory notice.

The insured's appeal regarding the calculation of legal expenses was also allowed, as the arbitrator had mistakenly omitted the actual hearing hours when applying a 3:1 preparation-to-hearing ratio.

The applicant was injured in a motor vehicle accident shortly after immigrating to Canada.

He applied for income replacement benefits, relying on a written job offer from his brother's trucking company to establish a legitimate contract of employment under section 4(3) of the Statutory Accident Benefits Schedule.

The insurer denied the claim, arguing the applicant lacked the English skills and licensing to perform the job.

The arbitrator found the contract was legitimate, as the parties reasonably intended for the applicant to learn English and obtain his licenses while working.

The arbitrator awarded income replacement benefits, subject to deductions for post-accident income earned from delivering pizzas, and mandatory interest on overdue payments.

The claim for a special award was dismissed because the insurer's delay was due to the applicant's late production of necessary documentation.