Dr. Tony Iezzi

The applicant sought post-104-week income replacement benefits following a motor vehicle accident.

The respondent initially approved the benefits but denied them four days later based on the same Insurer's Examination reports.

The Tribunal found that the respondent's denial was a correction of the initial approval and that the applicant failed to prove a complete inability to engage in any employment for which he was reasonably suited.

The applicant's expert reports were given little weight due to a lack of objective testing and failure to outline functional limitations.

The claim for income replacement benefits and interest was dismissed.

However, the Tribunal awarded the applicant $500 in costs because the respondent breached a case conference report and order by producing documents 137 days late, which interfered with the efficiency of the dispute resolution process.

The applicant was injured in a motor vehicle accident and applied for a determination of catastrophic impairment.

The insurer's Designated Assessment Centre concluded she did not suffer a catastrophic impairment.

The arbitrator found that the applicant suffered a marked impairment in social functioning due to the accident, satisfying the definition of catastrophic impairment under section 2(1)(g) of the Schedule.

The arbitrator also assessed her physical impairments at 52% WPI, which combined with her psychological impairment would exceed the 55% threshold.

The applicant was awarded her expenses of the arbitration.

The appellant insurer appealed a trial decision awarding the respondent insured a substantial loss of earning capacity benefit (LECB) and interest on overdue payments.

The respondent, a university student who suffered cognitive deficits and depression following a motor vehicle accident, cross-appealed the trial judge's decision to lock in her pre-accident earning capacity.

The Court of Appeal dismissed the insurer's appeal, finding the trial judge correctly concluded the respondent's residual earning capacity was zero due to her psychological makeup, and correctly awarded interest from the date benefits were overdue.

The Court allowed the cross-appeal, holding that the pre-accident earning capacity must be adjusted as the insured ages pursuant to the statutory formula.

The insurer appealed an arbitration order that reinstated the insured's caregiver benefits and imposed a special award at the maximum rate.

The insurer had suspended benefits after the insured refused to attend two sets of multi-disciplinary medical examinations.

The Director's Delegate dismissed the appeal, upholding the arbitrator's finding that the requested examinations were not reasonably necessary given the extensive medical information already available, including Designated Assessment Centre (DAC) reports supporting the insured's disability.

The Director's Delegate also confirmed the special award, finding that the insurer acted unreasonably in ignoring the medical evidence and the concerns of the insured's treating practitioners regarding the excessive assessments.

The applicant was injured in a rear-end motor vehicle accident and received statutory accident benefits until the insurer terminated them.

She applied for arbitration, seeking ongoing weekly income benefits and medical/rehabilitation benefits.

The arbitrator found that the applicant suffered from chronic pain syndrome and remained disabled from her pre-accident job as an in-store demonstrator, entitling her to weekly benefits up to the 156-week mark.

However, the arbitrator concluded that the applicant was not continuously prevented from engaging in any suitable employment thereafter, and dismissed the claim for post-156 week benefits and further medical/rehabilitation benefits.