Janet Lynne Frank

The insurer brought a motion to compel the applicant to produce two defence medical reports generated in a companion tort action.

The applicant opposed production, arguing the reports were irrelevant and protected by the implied undertaking rule.

The arbitrator found that while the implied undertaking rule did not shield the applicant from producing the documents, the reports were of limited probative value because they pre-dated the termination of benefits and the 104-week period at issue.

Furthermore, the insurer had already conducted sufficient assessments under section 42 of the Schedule.

The motion for production was dismissed.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them after 104 weeks.

The applicant sought arbitration, claiming a complete inability to engage in any employment for which she was reasonably suited.

The arbitrator reviewed the applicant's education, training, and work history, noting she primarily worked part-time.

Relying on the consensus of the applicant's own medical experts that she could return to part-time sedentary work, the arbitrator found she did not meet the test for complete inability to work.

The application for income replacement benefits and a special award was dismissed.

The applicant sought her expenses following an arbitration decision regarding statutory accident benefits.

The arbitrator found that success was divided, as the applicant was unsuccessful in her claim for ongoing income replacement benefits and a special award, but successful in correcting the amount of her income replacement benefit and resisting the insurer's claim for repayment based on alleged fraud.

The arbitrator awarded the applicant one-half of her assessed expenses, calculated at Legal Aid rates rather than the requested maximum rate, resulting in an award of $11,414.28.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them.

The applicant sought ongoing benefits, while the insurer claimed repayment of all benefits paid, alleging wilful misrepresentation of her pre-accident medical history.

The arbitrator found that the applicant had a significant, undisclosed pre-accident history of chronic back pain and lacked credibility.

The arbitrator concluded that the applicant's ongoing disability was not caused by the accident, dismissing the claim for ongoing benefits.

However, the arbitrator ordered the insurer to pay a shortfall in the benefits already paid, as the applicant had a reasonable explanation for initially failing to disclose a second job.

The insurer's claim for repayment due to wilful misrepresentation was dismissed.

The applicant was injured in a rear-end motor vehicle accident and claimed statutory accident benefits, including income replacement benefits (IRBs) and medical rehabilitation expenses.

The insurer terminated IRBs based on medical assessments suggesting the applicant was not disabled.

The arbitrator found the applicant was substantially disabled from his pre-accident employment as a limousine driver due to chronic pain syndrome and fibromyalgia, entitling him to ongoing IRBs and a Loss of Earning Capacity (LEC) offer.

However, the arbitrator dismissed the claim for ongoing physical therapy expenses, finding them no longer reasonable or necessary.

Furthermore, the arbitrator determined the correct quantum of the IRB was $185 per week, not the previously paid $273.20, and ordered the applicant to repay the $9,387 overpayment due to his material misrepresentation regarding his income tax filings.

The applicant was struck by a car and claimed ongoing income replacement benefits and physiotherapy expenses.

The insurer terminated benefits, arguing she could return to her job as a light duty cleaner and sought to deduct alleged post-accident income.

The arbitrator found the applicant suffered a substantial inability to perform the essential tasks of her job due to accident-related knee tendinitis, entitling her to ongoing income replacement benefits.

The arbitrator also found no evidence of actual post-accident income to deduct, and allowed only one month of the claimed physiotherapy expenses, finding the remainder unreasonable.

The applicant sought various statutory accident benefits following a motor vehicle accident, including income replacement benefits, an education benefit, medical expenses, dependant care, and housekeeping expenses.

The insurer denied the claims.

The arbitrator found that while the applicant was not procedurally barred from claiming income replacement benefits, she failed to prove that her accident-related injuries substantially prevented her from performing the essential tasks of her employment.

The arbitrator also dismissed the claims for education, medical, dependant care, and housekeeping benefits due to a lack of credible evidence and documentary proof that the expenses were incurred or were reasonable and necessary as a result of the accident.