6 total
Insurer denied leave to rely on late-served arbitration brief and surveillance evidence absent extraordinary circumstances.
The Insurer brought a motion seeking relief from the strict time limits under the Dispute Resolution Practice Code to allow it to rely on a late-served arbitration brief, surveillance evidence, and witness lists.
The arbitrator dismissed the requests regarding the arbitration brief and surveillance evidence, finding no evidence of 'extraordinary circumstances' to justify the late service.
The Insurer was permitted to call only those witnesses specifically identified in the pre-hearing letter.
The arbitrator also ordered the Applicant to continue efforts to obtain his ODSP file but declined to order production of updated medical records or to quash a summons served on the Insurer's claims adjuster.
Insurer ordered to pay interim benefits and expenses as conditions of an adjournment caused by its counsel's conflict of interest.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
At the commencement of the arbitration hearing, the applicant successfully moved to exclude the insurer's counsel due to a conflict of interest, resulting in an adjournment.
The applicant sought interim benefits and expenses as conditions of the adjournment.
The arbitrator granted the request, ordering the insurer to pay ongoing non-earner and attendant care benefits until a final decision is rendered, as well as $11,938.29 for expenses thrown away by the adjournment, noting the insurer's conduct in forcing the delay.
Law firm ordered to withdraw as insurer's counsel due to concurrent representation of the applicant in a related tort action.
The applicant was injured in a motor vehicle accident and applied for accident benefits.
The insurer retained a law firm to defend the arbitration.
The applicant objected, noting that another lawyer at the same law firm was currently defending the applicant in a concurrent tort action arising from the same accident.
The arbitrator found that the applicant was a current client of the law firm, creating a clear conflict of interest under the 'bright line' rule from R. v. Neil.
Relying on the inherent jurisdiction to prevent abuse of process under the Statutory Powers Procedure Act, the arbitrator ordered the law firm to withdraw as counsel of record for the insurer and adjourned the arbitration sine die.
Arbitrator granted applicant's request for adjournment to retain new counsel and awarded insurer costs thrown away.
The applicant sought statutory accident benefits from the insurer following a motor vehicle accident.
At the outset of the arbitration hearing, the insurer raised procedural objections regarding the applicant's late service of the arbitration brief and failure to identify witnesses in accordance with the Dispute Resolution Practice Code.
The arbitrator waived the time requirements for the brief but excluded a witness the applicant intended to call due to lack of notice.
Following these rulings, the applicant's counsel requested to be removed from the record, and the applicant sought an adjournment to retain new counsel.
The arbitrator granted the removal of counsel and the adjournment, ordering the insurer entitled to its costs thrown away for the morning of the hearing.
Arbitrator affirms Desbiens approach, allowing combination of physical and psychological impairments for catastrophic impairment threshold.
The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment.
Her assessor combined physical and psychological impairments to reach a 55% whole person impairment, following the methodology in Desbiens v. Mordini.
The insurer's assessors refused to assign numeric ratings to psychological impairments, finding only a 20% impairment.
The arbitrator held that the Desbiens approach is binding and correct in law, allowing the combination of physical and psychological impairments.
Furthermore, the arbitrator found that issue estoppel applied, as the insurer had previously litigated and lost this exact issue against the applicant before the Director.
The applicant was declared catastrophically impaired.
Request to state a case to the Divisional Court on catastrophic impairment combining methodology declined.
The insurer requested that the Director of Arbitrations state a case to the Divisional Court under s. 285(1) of the Insurance Act regarding whether physical and psychological impairments can be combined to determine catastrophic impairment under the Statutory Accident Benefits Schedule.
The Director declined the request, finding that FSCO arbitrators have the specialized expertise to interpret the SABS and that the existing jurisprudence on the issue was not internally inconsistent.
The matter was directed to proceed to arbitration in the normal course.
