Dr. Michel Lacerte

The applicant was injured in a low-speed rear-end motor vehicle accident and claimed statutory accident benefits, including caregiver, attendant care, and housekeeping benefits, as well as a determination of catastrophic impairment.

The insurer denied the claims and sought repayment of an alleged overpayment.

The arbitrator found that the applicant's physical presentation of torticollis was inconsistent with extensive video surveillance showing her performing normal daily activities.

Relying on expert evidence that her symptoms had a psychogenic overlay and did not meet the threshold for catastrophic impairment under the AMA Guides, the arbitrator dismissed the claims for ongoing caregiver and housekeeping benefits, and the catastrophic impairment designation.

The applicant was awarded a modest amount for attendant care during the first 104 weeks.

The insurer's claim for repayment was dismissed due to inadequate notice, and the applicant's claim for a special award was denied.

The applicant, a taxi driver, was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and a special award.

The insurer terminated benefits based on a DAC assessment.

At the hearing, the insurer conceded entitlement, leaving the quantum of IRBs and the special award in dispute.

The arbitrator determined the applicant's gross annual income by including employer-paid EI premiums and a 5.5% allowance for tips, but rejected the applicant's claim for unrecorded cash fares due to a lack of corroborating documentation.

The claim for a special award was dismissed, as the insurer reasonably relied on its medical experts in maintaining its denial until the hearing.

The applicant was injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated her weekly caregiver benefits after 104 weeks, asserting she did not suffer a complete inability to carry on a normal life.

The applicant argued she suffered a substantial inability to engage in her pre-accident caregiving activities for her adult son, who had a severe brain injury.

The arbitrator found that the applicant's physical limitations, including osteoarthritis and restricted mobility, prevented her from meaningfully engaging in her pre-accident caregiving activities.

The arbitrator ordered the insurer to pay ongoing weekly caregiver benefits and interest, but denied the claim for a special award.

The applicant was injured in a motor vehicle accident and claimed ongoing caregiver benefits, housekeeping expenses, psychological counselling, and a special award after the insurer terminated her benefits.

The arbitrator found that the applicant suffered a substantial inability to perform caregiver tasks due to physical and psychological impairments until her condition stabilized in January 1999, awarding caregiver benefits for that period.

The arbitrator also awarded a nominal amount for housekeeping expenses and an $8,000 special award, finding the insurer unreasonably terminated psychological counselling and vocational retraining benefits without a reasonable basis.

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

The insurer terminated benefits after 156 weeks, arguing the applicant was no longer continuously prevented from engaging in suitable employment.

The arbitrator found that while the applicant could not return to his pre-accident heavy labour job, he was capable of returning to his former employment as a real estate salesperson.

The arbitrator noted the applicant's poor compliance with rehabilitation, evidence of malingering, and video surveillance showing him golfing without difficulty.

The claim for ongoing benefits was dismissed.

The insurer's claim for repayment of benefits was also dismissed as there was no evidence of fraud or error.

The applicant was struck by a car and claimed ongoing income replacement benefits (IRBs) due to a left knee injury.

The insurer terminated benefits after the applicant failed to attend a scheduled medical examination and refused to participate in rehabilitation.

The arbitrator found that the applicant was not disabled from her pre-accident employment beyond April 6, 1995, relying on medical evidence and surveillance footage showing her performing physical tasks.

However, the arbitrator awarded full IRBs for a brief one-week period because the insurer had prematurely terminated benefits prior to the scheduled examination date.

The applicant was awarded 50% of her arbitration expenses.

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, a truck driver, was injured in a motor vehicle accident and received statutory accident benefits.

He returned to work full-time for nearly six months before stopping due to chronic pain, and sought reinstatement of his weekly income benefits and vocational retraining.

The insurer argued that returning to work for more than 90 days after the two-year anniversary of the accident precluded further benefits under section 16(2) of the Schedule.

The arbitrator held that section 16(2) creates a rebuttable presumption of ineligibility, which the applicant successfully rebutted with medical evidence showing he was substantially disabled from his essential tasks.

The applicant was awarded weekly income benefits up to the 156-week mark and vocational retraining costs, but was denied benefits beyond 156 weeks as he failed to prove he was continuously prevented from engaging in any suitable occupation.

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

The applicant applied for arbitration, claiming an ongoing inability to perform her essential tasks as a Becker's store manager due to chronic pain and psychological factors.

The arbitrator found that the applicant's job was physically demanding and that she remained substantially unable to perform its essential tasks.

The arbitrator rejected the insurer's arguments that the applicant's disability was solely due to unrelated personal tragedies or pregnancy, and ordered the insurer to pay ongoing weekly income benefits, interest, and arbitration expenses.

The applicant was involved in two motor vehicle accidents in October 1990 and received weekly income benefits until April 1991.

He applied for arbitration after the insurer terminated his benefits, claiming he remained substantially unable to perform the essential tasks of his pre-accident employment as a security guard due to chronic pain.

The arbitrator found that the applicant's job was not physically demanding and that the medical evidence, including surveillance video, did not support a finding of substantial inability to work.

The claim for ongoing weekly income benefits was dismissed, but the applicant was awarded his arbitration expenses.