Dr. M. Bail

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them.

The applicant sought ongoing benefits, while the insurer claimed repayment of all benefits paid, alleging wilful misrepresentation of her pre-accident medical history.

The arbitrator found that the applicant had a significant, undisclosed pre-accident history of chronic back pain and lacked credibility.

The arbitrator concluded that the applicant's ongoing disability was not caused by the accident, dismissing the claim for ongoing benefits.

However, the arbitrator ordered the insurer to pay a shortfall in the benefits already paid, as the applicant had a reasonable explanation for initially failing to disclose a second job.

The insurer's claim for repayment due to wilful misrepresentation was dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on an occupational medicine examination.

The applicant was subsequently involved in a second motor vehicle accident but only sought benefits related to the first.

The arbitrator found that the applicant's evidence was inconsistent and that multiple medical specialists noted exaggerated pain behaviour and illness behaviour.

The arbitrator concluded that the applicant did not suffer a physiological or anatomical impairment from the first accident that disabled her from working, and that her psychological impairment did not prevent her from performing the essential tasks of her employment.

The application for arbitration was dismissed.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them, relying on reports from its medical examiners.

The applicant sought arbitration for ongoing income replacement benefits, medical expenses, housekeeping services, and a special award.

The arbitrator found that the applicant suffered from severe depression and post-traumatic stress disorder caused by the accident, rendering her substantially unable to perform her employment tasks.

The arbitrator rejected the insurer's psychiatric expert as a partisan advocate and found the insurer acted unreasonably in terminating benefits despite overwhelming evidence of the applicant's psychological disability.

The applicant was awarded all claimed benefits and a $10,000 special award.

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

The applicant sought ongoing benefits under subsection 12(5) of the Statutory Accident Benefits Schedule, claiming she was continuously prevented from engaging in any suitable employment due to a psychological disability.

The arbitrator found the applicant credible and rejected the insurer's argument, based on video surveillance and one psychiatric opinion, that she was feigning her disability.

The arbitrator concluded the accident significantly contributed to her post-traumatic stress disorder and major depression, rendering her totally disabled.

The arbitrator also fixed the weekly benefit amount at $311.66 based on the insurer's own accountant's report, and dismissed the insurer's claims for repayment and post-accident income deductions.

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

She applied for arbitration claiming ongoing weekly income benefits, medical expenses, and a special award.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment as a dispatcher/cashier due to ongoing physical and psychological injuries, including right arm weakness, anxiety, and depression caused by the accident.

The arbitrator awarded weekly income benefits for the disputed two-year period.

Claims for nutritional counselling, meal replacements, and a special award were dismissed due to insufficient evidence.

The arbitrator also ruled that the new expense provisions under the Automobile Insurance Rate Stability Act did not apply retroactively, denying the insurer's claim for expenses and awarding the applicant her expenses of the proceeding.