Dr. S. Esmail

The applicant sought a non-earner benefit and medical benefits for taxi expenses after the rear doors of a TTC bus closed on her.

The insurer denied the claims, arguing her impairments were due to long-standing pre-existing conditions, including severe heart disease and diabetes, rather than the minor bus incident.

The arbitrator found that the applicant failed to prove the accident continuously prevented her from engaging in substantially all of her pre-accident activities.

The medical evidence and surveillance video demonstrated she remained capable of performing her normal activities, and her post-accident decline was more likely attributable to her pre-existing health issues and the death of her husband.

The application was dismissed, and the insurer was awarded its expenses.

The applicant was struck by a motor vehicle and claimed statutory accident benefits, including income replacement benefits (IRBs) and housekeeping benefits.

The insurer terminated IRBs and housekeeping benefits, leading to arbitration.

The arbitrator found that while the applicant's complaints of pain were likely exaggerated and lacked objective medical evidence after January 2007, he was substantially disabled from performing his pre-accident employment until his shoulder bursitis healed.

The arbitrator awarded IRBs for a closed period but dismissed the claims for ongoing IRBs, housekeeping benefits, and the cost of a redundant functional abilities evaluation.

Each party was ordered to bear their own expenses.