Dr. W. M. Franks

The applicant, a minor who sustained a brain injury in a motor vehicle accident, was largely successful in a previous arbitration regarding his entitlement to case management services.

In this subsequent hearing on expenses, the insurer disputed the hourly rate claimed by the applicant's counsel, the expenses related to mediation, and the attendance fees for expert witnesses.

The arbitrator awarded the maximum hourly rate of $150 for the applicant's counsel, noting her skill and expertise in pursuing the complex claim.

The arbitrator also allowed the attendance fees for the expert witnesses but deducted expenses related to mediation.

The total expenses and disbursements were fixed at $18,061.15.

The Applicant was injured in a motor vehicle accident and received statutory accident benefits until the Insurer terminated them.

The Applicant applied for arbitration to reinstate weekly benefits, claim medical and rehabilitation expenses, and seek a special award.

The Arbitrator found no jurisdiction to determine the medical and rehabilitation benefits as they were not raised at mediation.

The Arbitrator held that the Applicant was substantially unable to perform her pre-accident essential tasks until the 156-week mark, entitling her to weekly benefits until December 12, 1994.

The claim for a special award was dismissed because the Insurer's termination of benefits, while incorrect, was not arbitrary or capricious.

The applicant sustained a catastrophic brain injury in a motor vehicle accident and applied for statutory accident benefits.

The arbitrator held that the applicant was not entitled to care benefits in excess of the $3,000 monthly limit under section 7 of the Schedule, as the services provided by his family were 'care' rather than 'nursing' services.

However, the arbitrator found that the applicant's current inaccessible apartment was impeding his rehabilitation and ordered the insurer to provide rehabilitation benefits for accommodation with specific accessibility features, noting that purchasing and renovating a house was a reasonable option under section 6.

The arbitrator also granted a special award of $3,000 due to the insurer's unreasonable delay in paying certain medical and rehabilitation benefits.