6 total
Arbitrator dismisses claims for accident benefits due to insufficient evidence and denies insurer's request for assessment fee repayment.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, medical benefits for physiotherapy and chiropractic treatment, and expenses for treatment plans and family physician fees.
The insurer terminated income replacement benefits based on an orthopaedic assessment and disputed the other claims.
The arbitrator dismissed the applicant's claims, finding insufficient evidence to support her inability to work or the necessity of the disputed medical expenses.
The arbitrator also dismissed the insurer's claim for repayment of its assessment fee, concluding the arbitration was not frivolous or vexatious from the outset.
Arbitration order denying income benefits rescinded due to factual errors undermining adverse credibility findings.
The appellant was injured in a motor vehicle accident and claimed weekly income benefits for chronic pain and depression.
The arbitrator denied the claim, finding the appellant not credible based on alleged pre-existing conditions, surveillance evidence, and hearing observations.
On appeal, the Director's Delegate found that the arbitrator made serious factual errors regarding the pre-accident medical records and misapprehended the surveillance evidence.
Because these errors undermined the core credibility findings, the appeal was allowed, the arbitration order was rescinded, and the matter was remitted for a new hearing before a different arbitrator.
Appeal of arbitration decision denying weekly income benefits dismissed; arbitrator's preference for specialist evidence upheld.
The appellant appealed an arbitration decision denying his claim for weekly income benefits following a motor vehicle accident.
The appellant argued the arbitrator failed to give proper weight to evidence of a flare-up of back problems and a bulging disc.
The Director's Delegate dismissed the appeal, finding that the arbitrator properly weighed the evidence, preferring the uniform opinions of several orthopaedic specialists over the appellant's general practitioner.
The arbitrator's conclusion that the appellant was not substantially unable to perform the essential tasks of his pre-accident work was supported by the evidence.
No appeal expenses were awarded.
Applicant awarded weekly income benefits for psychological injuries up to March 24, 1993, and ongoing rehabilitation benefits.
The Applicant was injured in a motor vehicle accident and received statutory accident benefits.
The Insurer terminated weekly income benefits, and the parties proceeded to arbitration.
The arbitrator found that the Applicant's physical injuries had largely resolved, but she continued to suffer a substantial inability to perform the essential tasks of her occupation due to psychological injuries until March 24, 1993.
The Applicant was awarded weekly income benefits up to that date, as well as supplementary medical and rehabilitation benefits for her residual psychological injuries.
The Insurer was entitled to repayment of weekly income benefits paid after March 24, 1993.
Arbitrator limits weekly income benefits and denies most supplementary claims due to applicant's lack of credibility.
The applicant, a self-employed motorcycle mechanic, was injured in a motor vehicle accident and received weekly income benefits until they were terminated by the insurer.
He applied for arbitration claiming entitlement to maximum weekly benefits, supplementary medical and rehabilitation benefits, and care benefits.
The arbitrator found the applicant lacked credibility due to inconsistent testimony, failure to declare income for tax purposes, and surveillance evidence showing him performing physical tasks without restriction.
The arbitrator concluded the applicant failed to prove ongoing disability beyond March 21, 1991, and awarded minimum weekly benefits up to that date.
Claims for a rental vehicle and further therapy were denied, but full mileage for travel to his chiropractor was allowed.
Application for weekly benefits dismissed; undisclosed surveillance video excluded for breaching the rule in Browne v. Dunn.
The applicant, a pedestrian whose foot was run over by a car, sought weekly no-fault benefits after the insurer terminated them.
During the arbitration, the insurer attempted to introduce undisclosed surveillance video to impeach the applicant's credibility.
The arbitrator excluded the video, applying the rule in Browne v. Dunn, because the insurer failed to put the evidence to the applicant during cross-examination, which would cause undue prejudice and delay in an arbitration context.
On the merits, the arbitrator found that while the applicant suffered discomfort from his injuries, he failed to establish a substantial inability to perform his essential tasks.
The application for weekly benefits and interest was dismissed.
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