Dr. Zeldin

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs), transportation expenses, and the cost of a medical assessment.

The insurer denied the benefits, arguing the applicant had returned to work and did not meet the disability tests.

The arbitrator found the applicant suffered a substantial inability to perform her pre-accident employment for the first 104 weeks and a complete inability to engage in suitable employment thereafter until she commenced a new career.

The arbitrator awarded the IRBs, transportation expenses, and assessment costs.

Furthermore, the arbitrator ordered the insurer to pay a $10,000 special award because it unreasonably withheld IRBs by failing to have its accountant review updated financial information that would have revealed flaws in its initial denial.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them after the 156-week mark.

The applicant sought ongoing benefits under subsection 12(5)(b) of the Statutory Accident Benefits Schedule, arguing she was continuously prevented from engaging in suitable employment.

The arbitrator found that the applicant lacked the physical capacity to return to her former physically demanding jobs and lacked the skills for sedentary office work without further retraining.

The arbitrator ordered ongoing weekly income benefits.

Additionally, the arbitrator awarded a $10,000 special award under section 282(10) of the Insurance Act because the insurer unreasonably terminated benefits without proper notice or justification.

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

The insurer terminated weekly income benefits after 156 weeks, relying on surveillance videotape and a medical report.

The applicant sought ongoing weekly income benefits, supplementary medical and rehabilitation expenses, and a special award.

The arbitrator found that the applicant's back pain was caused by a combination of the accident, pregnancies, endometriosis, and deconditioning.

The arbitrator concluded that the applicant was disabled from suitable employment at the 156-week mark but would have been capable of returning to work had she continued her exercise program.

Weekly income benefits were awarded for an additional six months.

Claims for child care, physiotherapy, continuing education, and a special award were dismissed.

The applicant was injured in a rear-end motor vehicle accident and received statutory accident benefits, including caregiver and housekeeping benefits, which were subsequently terminated by the insurer.

The applicant sought ongoing caregiver benefits, housekeeping expenses, and the cost of medical reports.

The arbitrator found the applicant's testimony regarding her pre-accident and post-accident activity levels to be vague and contradictory, and noted inconsistencies with surveillance evidence.

Consequently, the arbitrator concluded that the applicant failed to establish on a balance of probabilities that she suffered a substantial inability to engage in caregiving activities or a partial inability to carry on a normal life.

The medical opinions were also deemed unreliable as they were based on the applicant's unreliable self-reporting.

The application for ongoing benefits was dismissed.

The applicant, a taxi driver, was injured in a motor vehicle accident and received weekly income benefits until January 1994.

He applied for reinstatement of benefits, claiming ongoing physical and psychological injuries rendered him substantially unable to perform his essential tasks.

The arbitrator found the applicant's evidence contradictory and unsupported by the medical reports, which largely recommended a return to work.

The claims for ongoing weekly income benefits and a special award were dismissed, though the applicant was awarded his arbitration expenses.

The appellant appealed an arbitrator's decision denying her weekly income and dependent care benefits following a motor vehicle accident.

She requested an oral rehearing, a referral to the Medical and Rehabilitation Advisory Panel, and a reinstatement of benefits, arguing the arbitrator misapplied the test for 'substantial inability' to perform essential tasks as a homemaker.

The Director of Arbitrations dismissed the appeal, finding no grounds to order a rehearing or a medical referral.

The Director upheld the arbitrator's conclusion that while the appellant experienced pain and her tasks took longer, she did not suffer a substantial inability to perform her essential tasks.

The appellant was awarded her expenses for the appeal.