Harry Brown

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

The insurer paid the maximum limit allowable.

The applicant's litigation guardian repeatedly failed to attend pre-hearings and had filed a parallel tort claim in the Superior Court of Ontario duplicating the issues.

The insurer moved to dismiss the arbitration application.

The arbitrator dismissed the application for arbitration forthwith, finding the proceeding frivolous or vexatious under Rule 68.1 of the Dispute Resolution Practice Code due to the litigation guardian's actions and failure to appear.

The applicant was injured in a motor vehicle accident and the parties settled the issues in dispute.

A consent order was requested regarding expenses.

The arbitrator ordered, on consent, that the applicant pay $2,500 to the insurer and sign a full and final release for all claims.

The parties settled the issues in dispute in the arbitration regarding a motor vehicle accident and requested a consent order regarding expenses.

The arbitrator issued a consent order requiring the applicant to pay $2,500 to the insurer and sign a full and final release for all past, present, and future claims.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After failing to attend two scheduled pre-hearing discussions without explanation, her counsel was removed from the record due to a breakdown in the solicitor-client relationship.

The insurer brought a motion to dismiss the application.

The arbitrator found that the applicant's complete disregard for the proceedings rendered the application frivolous, vexatious, or commenced in bad faith, and dismissed the application to prevent an abuse of process.

The plaintiff brought a motion under rule 21.01 seeking a declaration that her injuries constituted an "accident" under s.2(1) of the Statutory Accident Benefits Schedule, thereby entitling her to statutory accident benefits.

The incident occurred when the plaintiff was injured while a taxi driver attempted to move a motorized scooter to transport a passenger to a wheelchair-accessible taxi.

The court applied the two-part test requiring that the injury arise from the use or operation of an automobile and that such use directly cause the impairment.

Although the taxi was being used for its intended purpose, the court held the injury was caused by the driver's handling of the scooter, an intervening act unrelated to the use or operation of the taxi.

The motion for a declaratory order was therefore dismissed.

The applicant brought a motion seeking to appeal a Superior Court decision dismissing its appeal from an arbitration award without obtaining leave.

The applicant argued that section 6(1)(b) of the Courts of Justice Act provided an appeal as of right, despite section 49 of the Arbitration Act requiring leave.

The Court of Appeal dismissed the motion, holding that the specific provisions of the Arbitration Act prevail over the general provisions of the Courts of Justice Act, and therefore leave to appeal is required.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for breast reconstruction surgery in Germany, arguing that neck injuries from the accident prevented her from undergoing the procedure in Ontario under general anesthesia with intubation.

The arbitrator dismissed the claim, finding no evidence that the applicant was a candidate for the overseas surgery or that it was reasonable and necessary, especially since medical evidence indicated the procedure could be performed in Ontario without intubation.

Claims for a rehabilitation clinic account and unspecified future surgeries were also dismissed, as the former was settled directly by the insurer and the latter lacked particulars and had not been mediated.

The applicant, who was self-represented, sought statutory accident benefits following a motor vehicle accident.

The insurer raised concerns about the applicant's mental capacity to manage the arbitration process without counsel, citing a past psychological report and her conduct at pre-hearings.

The arbitrator considered whether a litigation guardian should be appointed under Rule 10 of the Dispute Resolution Practice Code.

Applying the presumption of capacity under the Substitute Decisions Act, the arbitrator found insufficient medical evidence to displace the presumption.

The arbitrator ruled that the applicant was not barred from proceeding without a litigation guardian.

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

The insurer denied the application, and the applicant subsequently submitted two more applications for the same determination more than two years later, arguing that a change in the law permitted re-application.

The insurer argued the arbitration was time-barred under s. 281(5) of the Insurance Act.

The arbitrator held that the two-year limitation period applies to catastrophic impairment determinations and runs from the date of a valid refusal.

Because the applicant's subsequent applications were based on the same criteria and did not demonstrate a change in condition, the limitation period was not reset.

The application for arbitration was dismissed as time-barred.

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

A dispute arose over the calculation of her income replacement benefit when she returned to work on modified duties.

The applicant argued that her post-accident income should be deducted from her calculated base benefit of $532, while the insurer argued it should be deducted from the maximum payable benefit of $400.

The arbitrator found the legislation unambiguous and held that post-accident income must be deducted from the maximum payable benefit of $400, not the base calculated amount.

The respondent slipped and fell on ice after exiting a taxi cab and walking towards her hotel.

She applied for statutory accident benefits, and an arbitrator initially found the incident constituted an 'accident' under the Statutory Accident Benefits Schedule.

The insurer appealed.

The Director's Delegate allowed the appeal, finding that the respondent had safely exited the vehicle and commenced walking before she fell.

The use or operation of the taxi cab was not a direct cause of her impairment, and the incident fell outside the scope of the 'accident' definition.

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 insurer brought a motion seeking an order confirming its right to speak privately with members of a Designated Assessment Centre (DAC) assessment team to prepare them for an upcoming arbitration hearing, and an order that it was not obliged to disclose the details of those conversations.

The arbitrator dismissed the motion, finding that DAC assessors hold a unique, neutral statutory role in the dispute resolution process.

Maintaining the actual and perceived neutrality of DAC assessors outweighs concerns about hearing efficiency and witness preparation.

Consequently, there is no right to one-sided partisan contact with a DAC assessor prior to a hearing.

The appellant appealed the dismissal of her action for a declaration of entitlement to statutory accident benefits.

She claimed the motor vehicle accident caused or contributed to her rheumatoid arthritis.

The trial judge found the accident was relatively minor and that the expert evidence did not establish it was more probable than not that the accident caused or triggered the onset of the arthritis.

The Court of Appeal found no error in the trial judge's approach to causation or assessment of the evidence and dismissed the appeal.

The applicant was injured when she slipped and fell on ice after exiting a taxi cab.

She applied for statutory accident benefits, which the insurer denied on the basis that the fall was not an 'accident' under section 2(1) of the Statutory Accident Benefits Schedule.

The arbitrator found that the location and orientation of the taxi compelled the applicant to walk around it, leading her to the ice.

The arbitrator concluded that the use or operation of the taxi was a direct cause of the impairment, satisfying the definition of an accident.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits and housekeeping expenses from her insurer.

The insurer had terminated benefits based on a Designated Assessment Centre report.

The arbitrator found the DAC report unreliable due to internal inconsistencies and miscommunication between its authors.

Based on the applicant's post-accident employment record as a television extra, the arbitrator determined she was entitled to income replacement benefits until October 2004, when she returned to her pre-accident earning capacity.

The arbitrator also awarded $640 for housekeeping expenses incurred before the two-year post-accident mark, plus interest and $100 in expenses.

The insurer appealed an arbitration order requiring it to pay transportation expenses for a minor insured who was driven to medical appointments by her parents in their own vehicles.

The trips were all under 50 kilometres.

The Director's Delegate allowed the appeal, finding that the 50-kilometre exemption in s. 14(6) of the SABS-96 and the Transportation Expenses Guideline applied to trips taken in a family vehicle.

The insurer was not liable for the transportation expenses.

The applicant applied for arbitration seeking income replacement benefits and reimbursement for an occupational therapy assessment following a motor vehicle accident.

Shortly after, the applicant's representative withdrew the application and ceased acting for him.

The applicant failed to respond to communications or attend the pre-hearing and the hearing regarding withdrawal conditions.

The arbitrator granted the withdrawal and ordered the applicant to pay the insurer's expenses of $600.32, finding that while the claim for the assessment was not necessarily frivolous, the applicant's failure to communicate or attend unnecessarily lengthened the proceeding.

The applicant sought to withdraw her application for arbitration of statutory accident benefits in order to commence a civil proceeding.

The insurer consented to the withdrawal on the condition that the applicant pay the insurer's $2,000 assessment fee and be barred from reapplying for arbitration on the same issues.

The arbitrator granted the motion to withdraw, finding no abuse of process that would justify ordering the applicant to pay the assessment fee under section 282(11.2) of the Insurance Act.

The arbitrator declined to bar the applicant from reapplying, noting the insurer could renew its motion if she did so.

The Applicant was injured in two motor vehicle accidents occurring four months apart.

The Insurer paid statutory accident benefits after the first accident but later terminated them.

Following the second accident, the Insurer resumed paying benefits, which the Applicant argued were a reinstatement of benefits for the first accident.

The Applicant applied for mediation more than two years after the initial termination.

The Arbitrator found that the Insurer's termination letter was clear and unequivocal, and the subsequent payments were attributable to the second accident.

Consequently, the Applicant's claim for benefits relating to the first accident was barred by the two-year limitation period under section 281(5) of the Insurance Act.