Jesse Hawley

The applicant sought expenses following an arbitration where she had mixed success in claiming statutory accident benefits.

The insurer argued that it enjoyed a greater degree of success and that the applicant unnecessarily prolonged the proceeding by calling six expert witnesses and being tardy in providing medical and financial records.

The arbitrator found that while the applicant's success was mixed, she was forced to proceed with the arbitration to obtain any benefits, as the insurer refused to acknowledge liability until the eve of the hearing.

The arbitrator awarded the applicant her reasonable expenses, with some reductions for unnecessary testimony and excessive preparation time, totaling $20,637.64 inclusive of fees and disbursements.

The applicant was injured in a motor vehicle accident and applied for income replacement benefits.

The insurer paid benefits at a lower rate, arguing the applicant was self-employed at the time of the accident.

The applicant argued he was an employee, having recently accepted a job at a new auto body shop for a fixed weekly salary.

The arbitrator found that the applicant met the definition of an employee under the Statutory Accident Benefits Schedule, noting that he had no ownership interest, bore no financial risk, and worked set hours for a fixed wage.

The arbitrator ordered the insurer to pay income replacement benefits at the higher employee rate of $294.12 per week, plus interest on overdue payments.