Dr. Juan Escudero

The applicant sought expenses following a successful arbitration for statutory accident benefits.

The insurer disputed the hourly rate claimed for the applicant's counsel and the preparation time claimed for expert witnesses.

The arbitrator held that under the applicable regulation in force at the time the application was filed, the maximum hourly rate for legal fees was restricted to the Legal Aid Act rate of $83.75, and expert preparation time was not recoverable.

The arbitrator awarded the applicant $13,100.73 for legal expenses and $8,889.42 for disbursements.

The insurer appealed an arbitration decision that reinstated the claimant's income replacement benefits and ordered a $5,000 special award.

The Director's Delegate allowed the appeal, finding that the arbitrator failed to provide a reasonable explanation for her factual findings, unfairly restricted and ignored the evidence of the insurer's medical expert regarding surveillance video, and failed to adequately address the complexity of the conflicting medical evidence.

The arbitration order was rescinded, the special award was overturned because the insurer reasonably relied on a Designated Assessment Centre report, and a new hearing before a different arbitrator was ordered.

The applicant was injured in a motor vehicle accident while riding his bicycle and subsequently claimed income replacement benefits.

The insurer terminated these benefits based on a Designated Assessment Centre report.

The arbitrator found that the applicant was substantially disabled from performing the essential tasks of his pre-accident employment, which included multiple labour-intensive part-time jobs.

The arbitrator preferred the evidence of the applicant's medical experts over the insurer's assessors.

Furthermore, the arbitrator awarded a $5,000 special award, finding that the insurer acted unreasonably by ignoring additional medical evidence that supported the applicant's claim.