Dr. Walsh

Following an arbitration hearing where the insurer was almost entirely successful in defending the applicant's claims for statutory accident benefits, the insurer sought its expenses of the proceeding.

The arbitrator found that the insurer was entitled to its reasonable expenses based on its degree of success.

After reviewing the hours claimed and applying the appropriate Legal Aid rates, the arbitrator fixed the insurer's expenses at $15,000, inclusive of fees, disbursements, and taxes, and ordered the applicant to pay this amount.

The appellant was injured in a motor vehicle accident and received weekly income benefits for approximately two years before the insurer terminated them.

The arbitrator found that the appellant was not eligible for further benefits, concluding that his failure to resume employment was due to an unreasonable refusal to work rather than a genuine psychological disability.

On appeal, the appellant argued the arbitrator failed to give due weight to his psychiatrist's report and was biased.

The Director's Delegate dismissed the appeal, finding that the arbitrator's assessment of the evidence was reasonable and supported by the record.

The Delegate also refused to admit new medical evidence on appeal and upheld the arbitrator's decision to award the appellant only one-third of his arbitration expenses.

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

The applicant sought ongoing benefits, claiming physical and psychological disability.

The arbitrator found that the applicant's physical injuries had resolved and that there was no organic basis for his ongoing complaints.

Medical and vocational assessments indicated symptom magnification, malingering, and an unreasonable refusal to attempt a return to work.

The arbitrator concluded the applicant was not disabled beyond the termination date.

However, the arbitrator found the insurer had miscalculated the benefit amount prior to termination by improperly deducting ceasing business expenses, resulting in an underpayment.

The insurer was ordered to pay the arrears with interest, and the applicant was awarded one third of his hearing expenses.