Dr. Robert S. Yufe

The applicant sought statutory accident benefits following a 2020 motor vehicle accident, including income replacement benefits (IRBs), various treatment plans, and an award for unreasonable delay.

The respondent denied the benefits, arguing the applicant's impairments were due to pre-existing degenerative disc disease and a prior 2016 accident.

The Tribunal found the applicant failed to prove her impairments were caused by the subject accident, relying on the respondent's s. 44 assessors who concluded her physical and psychological complaints were not accident-related.

All claims for IRBs, treatment plans, assessments, interest, and an award were dismissed.

The respondent's request for costs was also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent held the applicant within the Minor Injury Guideline (MIG) and denied three treatment plans.

As a preliminary issue, the Tribunal found the applicant was not barred by the two-year limitation period for one of the plans, as O. Reg 73/20 extended the period by 183 days due to the COVID-19 pandemic.

On the substantive issues, the Tribunal found the applicant failed to demonstrate that his injuries warranted removal from the MIG, preferring the respondent's psychological assessment over the applicant's.

The applicant was entitled to the remaining balance of the $3,500 MIG limit for a disputed physiotherapy plan, but the two psychological treatment plans were denied as they proposed treatment outside the MIG.

The applicant was injured in a pedestrian knockdown and sought ongoing income replacement and medical benefits.

The insurer terminated benefits, alleging the applicant was exaggerating her symptoms and sought repayment of an overpayment.

The arbitrator found the applicant's presentation of chronic pain and emotional impairments to be genuine, rejecting the insurer's expert who admitted a bias toward skepticism.

The applicant was awarded ongoing income replacement benefits as she was completely unable to engage in suitable employment.

The insurer's claim for repayment was dismissed as the overpayment resulted from an employer error, not the applicant's wilful misrepresentation.

Medical benefits were partially awarded.

The applicant was injured in a serious motor vehicle accident and received income replacement benefits (IRBs).

The insurer terminated IRBs after the applicant attempted a return to work but had to stop due to severe headaches and vomiting.

The insurer later reinstated benefits and paid arrears on the eve of the arbitration hearing.

The arbitrator found that the insurer unreasonably withheld benefits by ignoring the overwhelming medical evidence from treating practitioners and selectively reading its own experts' reports.

The arbitrator awarded a special award of $25,000, inclusive of compound interest, under s. 282(10) of the Insurance Act.

The applicant, a taxi driver, was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and a special award.

The insurer terminated benefits based on a DAC assessment.

At the hearing, the insurer conceded entitlement, leaving the quantum of IRBs and the special award in dispute.

The arbitrator determined the applicant's gross annual income by including employer-paid EI premiums and a 5.5% allowance for tips, but rejected the applicant's claim for unrecorded cash fares due to a lack of corroborating documentation.

The claim for a special award was dismissed, as the insurer reasonably relied on its medical experts in maintaining its denial until the hearing.