Dr. Lynne MacGregor

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them, alleging his ongoing disability was due to a pre-existing congenital neck condition, degenerative changes, or self-limitation.

The arbitrator found that while the congenital condition was not caused by the accident, the accident injuries combined with the fear generated by the discovery of the condition led to a chronic pain syndrome.

The arbitrator rejected the insurer's video surveillance evidence as proof of ability to return to work and ordered the reinstatement of income replacement benefits.

The insurer appealed an arbitration order requiring it to pay ongoing income replacement benefits and a special award to the respondent, a self-employed home daycare provider injured in a motor vehicle accident.

The insurer argued the arbitrator erred in assessing the physical demands of the respondent's job and in rejecting the evidence of the Designated Assessment Centre (DAC) assessors, who concluded she could return to work.

The Director's Delegate dismissed the appeal, finding no error of law in the arbitrator's preference for the respondent's medical evidence over the DAC assessment, nor in the finding that the insurer acted unreasonably in terminating benefits on multiple occasions.

The insured was injured in a motor vehicle accident and claimed the cost of a home whirlpool spa as a medical expense.

The insurer denied the claim, relying on a Designated Assessment Centre report.

The arbitrator denied the cost of the specific spa purchased but ordered the insurer to pay the reasonable cost of a Jacuzzi-type bathtub.

The insurer appealed, arguing the arbitrator exceeded her jurisdiction and erred in her treatment of the medical certificate and DAC report.

The Director's Delegate dismissed the appeal, finding the arbitrator's order reasonably arose from the evidence and submissions, and that there was sufficient evidence to support her findings.

The applicant was injured in a motor vehicle accident and received weekly income benefits from the insurer.

The insurer terminated benefits, arguing the applicant was capable of working and that his disability was caused by his bankruptcy rather than the accident.

The arbitrator found that the applicant suffered from chronic pain syndrome caused by the accident, which continuously prevented him from engaging in any occupation for which he was reasonably suited by education, training, or experience.

The arbitrator also found that the parties had previously settled the quantum of benefits at $600 per week.

The insurer's claim for repayment was dismissed.

A special award of $600 was granted because the insurer unreasonably withheld benefits by failing to provide proper notice of its reasons for termination.

The applicant sought weekly, death, and funeral benefits on behalf of his deceased father, who was involved in two minor motor vehicle accidents in December 1992 and subsequently experienced a rapid decline in health, dying in June 1993.

The arbitrator found that while the accidents caused an initial inability to perform essential tasks, entitling the estate to weekly benefits for a limited period, they did not directly or indirectly cause the death.

Medical evidence suggested an underlying malignancy was the likely cause of the rapid deterioration and death.

Claims for death benefits, funeral expenses, and a special award were dismissed, but the applicant was awarded expenses of the arbitration.