Ronald Mix

The applicant sought payment of legal expenses following an arbitration regarding statutory accident benefits.

The insurer argued the applicant was only entitled to half his expenses due to divided success.

The arbitrator found the applicant was the successful party overall and entitled to his full reasonable legal expenses.

The arbitrator assessed the legal fees based on a reasonable preparation-to-hearing ratio and allowed an hourly rate of $150 for counsel.

The applicant was awarded $38,409.44 in legal expenses and disbursements.

The parties cross-appealed an arbitrator's decision regarding the insured's entitlement to loss of earning capacity benefits (LECBs) and rehabilitation expenses following a motor vehicle accident.

The Director's Delegate upheld the arbitrator's calculation of the self-employed insured's pre-accident earning capacity (PEC), finding no error of law in the factual assessment.

However, the Delegate allowed the insurer's appeal regarding residual earning capacity (REC), holding that the arbitrator erred in law by shifting the onus to the insurer to prove the availability of suitable alternative employment.

The REC was reassessed at $145.30 per week, reducing the weekly LECB to $358.10.

The insured's appeal for the cost of labour to complete his home construction was dismissed as it did not serve a rehabilitative purpose under section 40 of the SABS.

The applicant was injured in a motor vehicle accident and claimed that his weekly income benefits should have been higher than the $185.60 paid by the insurer.

The applicant operated a towing and scrap metal business and claimed he sold several cars for a substantial profit shortly before the accident.

The arbitrator found that the applicant was entitled to include the income from the sale of four cars in the calculation of his average gross weekly income for the four weeks before the accident, based on a list provided to the insurer.

The determination of the exact weekly income benefit amount was deferred pending recalculation by the parties.

The applicant was also awarded his arbitration expenses.