Dr. Vlasta Hajek

Following an arbitration and appeal regarding statutory accident benefits, the applicant sought an assessment of his arbitration expenses.

The insurers argued that the appeal automatically stayed the arbitration expenses order, but the arbitrator noted that under the Insurance Act, an appeal does not stay an order unless the Director decides otherwise.

The arbitrator assessed the applicant's claimed legal fees and disbursements, allowing a portion of the preparation time and expert witness fees.

After accounting for set-offs for collateral benefits and the insurers' appeal expenses, Allstate was ordered to pay $3,569.45 and Wellington was ordered to pay $6,381.95.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them after 156 weeks.

The applicant sought reinstatement of benefits, while the insurer sought repayment of benefits, arguing that Canada Pension Plan (CPP) disability payments should have been deducted from the applicant's gross weekly income.

The arbitrator found that the applicant was not continuously prevented from engaging in a suitable alternative occupation, relying on surveillance video that contradicted the applicant's reported physical limitations.

The arbitrator also held that CPP benefits are non-indemnity payments and therefore not deductible from gross weekly income under the Schedule.

Both the claim for ongoing benefits and the claim for repayment were dismissed.