Jason R. Frost

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The insurer terminated IRBs after 104 weeks, arguing the applicant did not meet the test for complete inability to work.

The Tribunal found that while the applicant failed to prove physical impairment, he successfully established that his psychological impairments, caused by the accident, rendered him completely unable to engage in any employment for which he was reasonably suited.

The Tribunal awarded IRBs from November 15, 2015, ongoing, with interest.

The respondent's request for costs was denied.

The applicant and respondent insurers were engaged in a priority dispute regarding statutory accident benefits.

Following the death of the original arbitrator, the parties could not agree on a substitute.

The applicant brought an application under the Arbitration Act, 1991 to appoint a new arbitrator.

The court appointed the applicant's proposed choice, the Honourable Douglas Cunningham, finding that the dispute involved novel legal arguments and issues of deflection, making an arbitrator with extensive judicial experience preferable to one with specialized insurance adjusting experience.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders, non-earner benefits, and attendant care benefits.

The arbitrator dismissed all claims, finding that the applicant was malingering.

The arbitrator rejected the applicant's expert evidence due to flawed methodology and inconsistencies, preferring the insurer's expert and surveillance evidence which showed the applicant engaging in normal daily activities.

The arbitrator also found the accident involved minor forces comparable to everyday activities, making the claimed severe impairments implausible.

Aviva appealed an arbitrator's decision in a priority dispute which found that Aviva was the priority insurer for accident benefits because it failed to prove the claimant was the 'spouse' of a driver insured by Security National.

Aviva argued the claimant and the driver were married in a foreign religious ceremony.

The Superior Court dismissed the appeal, holding that the arbitrator's decision was reasonable.

The court found that Aviva bore the burden of proof and failed to provide sufficient evidence of the date, place, or legal validity of the foreign marriage under the lex loci celebrationis.

The applicant sought attendant care benefits following a motor vehicle accident.

The Tribunal found that while the applicant's physical injuries fell within the Minor Injury Guideline (MIG), her psychological impairments (Major Depressive Disorder and Generalized Anxiety Disorder) took her outside the MIG.

However, the claim for attendant care benefits was dismissed because the applicant failed to prove the expenses were 'incurred' under section 3(7)(e) of the Schedule.

The evidence regarding care provided by family members was vague, lacked corroboration, and failed to establish economic loss or that the care was provided in the course of ordinary employment.

The appellant, Unifund Assurance Company, sought judicial review of an arbitration award that found its vehicle to be the "striking vehicle" under the "transmission of force" doctrine, making it responsible for a pedestrian's accident benefits.

The Superior Court reviewed the arbitrator's application of the legal principle of transmission of force, particularly in the context of two moving vehicles.

The court found that the arbitrator erred by not applying the reasoning from Trahan v Royal Insurance Co. of Canada, concluding that the ACE vehicle, despite being deflected, maintained its own independent force and propulsion.

Consequently, the court set aside the arbitration decision, finding ACE INA Insurance Company to be in highest priority and responsible for the claimant's statutory accident benefits, and ordered ACE to reimburse The Personal Insurance Group.

The applicant sought statutory accident benefits after a heavy metal garage door fell on him while he was walking through a doorway at a storage facility.

He had been loading items into a parked truck.

The insurer denied benefits on the basis that the incident was not an 'accident' under the Schedule.

The arbitrator found that while loading a vehicle is an ordinary use, the use or operation of the vehicle did not directly cause the applicant's injuries.

The falling garage door was an intervening act and the dominant feature of the incident.

The application for arbitration was dismissed.

The applicant, a long-haul truck driver, was injured in a motor vehicle accident in North Carolina.

He elected to opt out of the WSIB scheme to pursue a tort action and subsequently applied for statutory accident benefits.

The insurer argued that the applicant's tort claim was barred under North Carolina law due to contributory negligence, and that his election out of WSIB was made primarily to claim accident benefits, which would bar his claim under section 61 of the Schedule.

The arbitrator found the applicant credible and concluded that, at the time of the election, his primary purpose was to pursue a tort action to recover his losses.

Therefore, the election was valid and the claim for accident benefits was not barred.

The applicant was injured in a motor vehicle accident and sought attendant care benefits from his insurer.

The applicant claimed that his wife and son provided attendant care services.

The insurer paid an initial amount but denied further benefits on the basis that the service providers had not demonstrated an economic loss.

The arbitrator found that the son was receiving income replacement benefits and the wife did not substantiate an economic loss from her employment.

The claim for attendant care benefits was dismissed.

A heavy commercial vehicle insured by the appellant rear-ended a stopped vehicle, causing it to rear-end a third vehicle insured by the respondent.

The respondent paid statutory accident benefits to its insured and sought indemnification from the appellant under the loss transfer provisions of the Insurance Act.

The arbitrator and the Superior Court judge held that the appellant was 100 per cent responsible for the entire chain reaction under section 9(4) of the Fault Determination Rules.

The Court of Appeal allowed the appeal, holding that the word 'incident' in section 9(4) refers only to the specific collision between two vehicles, meaning the appellant was only at fault for the collision with the middle vehicle and not required to indemnify the respondent.

The applicant's representatives, Lofranco Corriero, brought a motion to be removed as solicitors of record due to an irreparable breakdown in the solicitor-client relationship.

The applicant failed to provide instructions, refused to proceed with recommendations, and could not be contacted.

The insurer did not oppose the motion.

The arbitrator found that the representatives had complied with Rule 9.7 of the Dispute Resolution Practice Code and granted the motion to remove them as representatives of record.

The insurer brought a preliminary issue seeking to dismiss the applicant's claim for income replacement benefits (IRBs) arising from a 2009 motor vehicle accident.

The insurer argued the claim was an abuse of process because the applicant failed to provide proof of income, failed to file tax returns, failed to attend insurer examinations, and had previously withdrawn the IRB claim.

The Arbitrator found that the applicant's conduct as a whole irrevocably prejudiced the insurer's ability to assess and defend the claim.

The claim for IRBs was dismissed as an abuse of process.

The plaintiff brought an action against her accident benefits insurer under the Statutory Accident Benefits Schedule and sought to avoid attending an oral examination for discovery due to alleged psychological harm.

The court held that the evidentiary record did not provide persuasive and compelling medical evidence that attendance for discovery, with appropriate accommodations, would cause significant psychological damage.

The court ordered that the plaintiff attend for examination for discovery and held that the defendant insurer was entitled to examine first under the Rules of Civil Procedure because it served the first affidavit of documents and notice of examination.

The court also ruled that an application for mediation under the Insurance Act does not automatically give rise to litigation privilege and does not, by itself, establish that litigation was reasonably contemplated.