Dr. Sergio Bacal

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

The insurer terminated her income replacement benefits, prompting the applicant to apply for arbitration.

Shortly before the hearing, the insurer reinstated the benefits and paid the arrears with interest.

The arbitration proceeded solely on the issue of whether the applicant was entitled to a special award under s. 282(10) of the Insurance Act.

The arbitrator found that the insurer acted unreasonably and engaged in flagrant misconduct by terminating benefits without meaningful medical evidence, ignoring overwhelming medical reports from its own assessors confirming the applicant's severe depression and disability, and improperly deducting collateral benefits.

The arbitrator awarded the maximum special award of 50% of the withheld benefits, amounting to $61,829.52.

The applicant was injured in a motor vehicle accident and received income replacement benefits for 104 weeks.

The insurer terminated benefits, and the applicant sought ongoing income replacement, attendant care, and housekeeping benefits.

The arbitrator found that the applicant did not suffer a complete inability to engage in suitable employment due to physical injuries, but did suffer such an inability due to psychological complications (severe depression and anxiety) until her condition stabilized.

The arbitrator awarded income replacement benefits for a closed period.

The claims for attendant care and housekeeping expenses were dismissed because the applicant failed to prove she incurred a cost or obligation to pay her husband for those services.

The Applicant was injured in a motor vehicle accident and claimed ongoing income replacement benefits.

The Insurer argued his condition was not caused by the accident and he was not motivated to return to work.

The Arbitrator found that the Applicant suffered continuous depression, reduced cognitive skills, and chronic pain as a result of the accident.

Due to these cognitive and physical disabilities, the Applicant suffered a substantial inability to perform the essential tasks of his job as a welder.

The Arbitrator ordered the Insurer to pay ongoing income replacement benefits and the expenses of the arbitration.

The Applicant sought ongoing weekly income benefits following a minor motor vehicle accident.

The Insurer terminated benefits after 10 months.

The Arbitrator found the Applicant's claims of disabling physical and psychological pain to be unsupported by objective medical evidence and contradicted by surveillance footage showing him engaging in normal activities without restriction.

The claim for ongoing benefits was dismissed.

The Applicant was awarded half of his arbitration expenses and the return of a $2,000 assessment fee, as the claim was not found to be frivolous or vexatious.

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.

The applicant, a self-employed restaurant owner, was injured in a motor vehicle accident and received weekly income benefits from the insurer until December 1992.

He applied for arbitration seeking ongoing benefits.

The arbitrator found that the applicant was no longer substantially disabled from performing the essential tasks of his occupation after December 1992, relying on extensive medical and rehabilitation evidence.

Furthermore, the arbitrator determined that the applicant had failed to prove his pre-accident income was higher than the deemed minimum, resulting in a finding that the insurer had significantly overpaid him.

The insurer was ordered to be repaid $28,593.60, and the applicant's claim for a special award was dismissed.