Dr. Martin Gillen

The insurer brought a motion to exclude the evidence and report of the applicant's treating physiatrist, arguing he was no longer a qualified practitioner under the Evidence Act due to the revocation of his medical license for professional misconduct.

The arbitrator dismissed the motion, holding that the Statutory Powers Procedure Act permits the admission of relevant evidence and that the prejudice to the applicant in excluding his long-term treating physician outweighed the insurer's concerns of impropriety.

The arbitrator also admitted transcripts of several witnesses from a previous arbitration hearing on consent.

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 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 applicant was successful in an arbitration for statutory accident benefits and was awarded her expenses.

In this expense assessment, the arbitrator determined the quantum of legal fees and disbursements payable by the insurer.

The arbitrator allowed a 3:1 ratio for preparation to hearing time, resulting in 260 hours for lead counsel.

The arbitrator also awarded an enhanced hourly rate of $150, noting that the insurer had unreasonably refused a settlement offer.

Additional fees were awarded for previous counsel, an articling student, and law clerks, along with disbursements including expert witness fees and court reporting services.

Following a decision on statutory accident benefits, the parties disputed the applicant's entitlement to arbitration expenses and the calculation of interest on a special award.

The arbitrator awarded the applicant her expenses of $19,048.46, finding that she achieved partial success and raised significant issues.

The arbitrator also clarified that the $5,000 special award previously ordered was inclusive of interest under subsection 282(10) of the Insurance Act.

The issue of ongoing loss of earning capacity benefits was deferred to a further pre-hearing.

The applicant, a taxi driver, was injured in a motor vehicle accident and received weekly income benefits for approximately one year.

He disputed the insurer's termination of benefits, claiming a substantial inability to perform the essential tasks of his occupation due to reduced working hours, and later claiming he was continuously prevented from engaging in any suitable occupation.

The arbitrator found the applicant's self-reported post-accident income records lacked credibility, particularly when contradicted by surveillance evidence showing he worked longer hours and took more fares than recorded.

The arbitrator concluded the applicant was capable of working 12-hour shifts and did not suffer a substantial inability, except for a brief period following sinus surgery.

The claim for ongoing benefits was dismissed as the temporary disability did not meet the continuity requirement.

The applicant, a child care provider, was injured in a rear-end motor vehicle accident and claimed statutory accident benefits.

The insurer terminated her weekly income replacement benefits on multiple occasions.

The arbitrator found the applicant credible and accepted medical evidence that she developed chronic pain syndrome as a result of the accident, rendering her substantially disabled from performing the essential tasks of her employment.

The arbitrator ordered the insurer to pay income replacement benefits for the disputed periods and ongoing.

Additionally, the arbitrator found the insurer acted unreasonably in prematurely terminating benefits and awarded a special award of $3,500, along with interest and arbitration expenses.

The Applicant was injured in two motor vehicle accidents and claimed statutory accident benefits.

The Insurer terminated her loss of earning capacity benefits and medical benefits, alleging she failed to attend an Insurer Examination.

The Arbitrator found that the Insurer was not entitled to terminate benefits because it had improperly requested a Designated Assessment Centre evaluation without following the required procedures.

The Arbitrator assessed the Applicant's residual earning capacity based on a DAC report and surveillance evidence, finding her capable of part-time self-employment.

The Applicant was awarded ongoing loss of earning capacity benefits, outstanding medical and housekeeping expenses, and a $5,000 special award for the Insurer's unreasonable termination of benefits.

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.

The applicant was seriously injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated her weekly income benefits after 156 weeks, arguing she was capable of returning to work.

The arbitrator found that the applicant suffered from chronic pain syndrome as a result of the accident and was continuously prevented from engaging in suitable employment.

The arbitrator ordered the insurer to pay ongoing weekly income benefits, denied the insurer's claim for repayment of an overpayment caused by its own error, and allowed the deduction of 80% of the applicant's actual post-accident earnings, but rejected the deduction of potential future income.

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

The applicant applied for arbitration, claiming ongoing entitlement under section 12(5)(b) of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant suffered from chronic pain syndrome resulting from the accident, which continuously prevented him from engaging in any employment for which he was reasonably suited by education, training, or experience, including the alternative position of a service advisor.

The arbitrator ordered the insurer to pay weekly income benefits from the date of termination, along with interest and arbitration expenses.

The applicant, a self-employed bricklayer, was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them.

The applicant sought reinstatement of benefits, claiming ongoing disability due to chronic neck and back pain.

The arbitrator found that while the applicant's pre-existing degenerative disc disease was aggravated by the accident, surveillance video demonstrating the applicant laying bricks showed he no longer had physical limitations preventing him from working.

The arbitrator concluded the applicant was entitled to benefits up to July 31, 1993, but failed to prove ongoing disability beyond that date.

The applicant was injured in a motor vehicle accident while a passenger on a bus.

She received weekly income benefits until they were terminated by the insurer.

The applicant sought reinstatement of weekly income benefits and payment for a secretarial course as a rehabilitation expense.

The arbitrator found that the applicant did not suffer a substantial inability to perform her pre-accident employment immediately following the termination of benefits, but that a subsequent brief return to work exacerbated her condition, entitling her to benefits thereafter.

The claim for the cost of the secretarial course was dismissed as the applicant failed to prove it was a reasonable and suitable rehabilitation expense given her physical limitations.