Jason Singer

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, which the respondent insurer denied.

The respondent raised a preliminary issue, arguing the applicant was barred from proceeding with his application before the Tribunal under section 55 of the Schedule for failing to fully participate in neuropsychological and psychological insurer's examinations under section 44.

The Tribunal found that the applicant had attended the examinations, though he did not complete all tasks.

Crucially, the Tribunal held that the respondent's notices for further psychological examinations were deficient because they failed to provide adequate medical or other reasons for the repetitive assessments.

Consequently, the respondent could not rely on section 55 to bar the application, and the applicant was permitted to proceed.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming he suffered from chronic pain that prevented him from working as a carpenter apprentice.

The adjudicator dismissed the application, finding the applicant's evidence and his expert's chronic pain assessment unreliable due to inconsistencies with the medical records, including evidence of prior injuries, altercations, and drug use.

The adjudicator preferred the respondent's orthopaedic and functional assessments, concluding the applicant failed to prove a substantial inability to perform his pre-accident employment for the pre-104 week period, or a complete inability to engage in suitable employment for the post-104 week period.

Claims for an award and interest were also dismissed.

The applicant claimed statutory accident benefits after allegedly being struck by a vehicle and hitting his head on a concrete planter.

The insurer stopped paying benefits and later raised the preliminary issue that the incident did not meet the definition of an 'accident' under the Schedule, while also seeking repayment of benefits already paid.

The arbitrator held that the insurer was not estopped from raising the 'no accident' defence.

On the merits, the arbitrator found the applicant failed to prove on a balance of probabilities that his injuries were caused by the use or operation of a motor vehicle, citing significant inconsistencies in witness testimony and timing.

However, the insurer's claim for repayment was dismissed as it failed to prove the applicant made wilful misrepresentations.

The applicant was struck on the head by a parking garage control arm while walking into the garage behind a car.

He applied for statutory accident benefits, but the insurer denied the claim, arguing the incident was not an 'accident' under section 2(1) of the Schedule.

The arbitrator found that the car entering the garage triggered the arm to lift and lower, satisfying both the purpose and causation tests.

The arbitrator concluded that the use or operation of the car directly caused the injury, and therefore the applicant was injured in an 'accident'.

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

A preliminary issue hearing was held to determine the quantum of his income replacement benefits, which depended on whether he was employed or self-employed at the time of the accident.

The arbitrator found that while the applicant's work for an employment agency had many indicia of employment, his tax status as a 'Code 11' placement worker allowed him to deduct business expenses.

Giving primary weight to how the employment was treated for tax purposes, the arbitrator concluded the applicant was self-employed and accepted the insurer's calculation of the benefit amount.

The insurer brought a motion to stay the arbitration proceeding until the applicant attended a section 42 assessment with a physiatrist.

The applicant had previously attended multiple insurer examinations and the insurer had consistently denied his claim for non-earner benefits.

The arbitrator found that the insurer's request, made almost a year after learning of the applicant's physiatrist treatment and only five months before the hearing, was primarily to bolster its case rather than adjust the claim.

The motion was denied as the proposed assessment was not reasonable and necessary at this time.

The applicant claimed statutory accident benefits following a motor vehicle accident.

The insurer scheduled multiple insurer examinations which the applicant failed to attend.

The insurer sought a preliminary ruling that the applicant was ineligible for caregiver, non-earner, attendant care, and housekeeping benefits during the period of non-compliance.

The arbitrator allowed the applicant's representative to withdraw due to a breakdown in the solicitor-client relationship.

The arbitrator found the applicant ineligible for attendant care and housekeeping benefits for specific periods due to her failure to attend reasonable examinations.

However, the insurer was not entitled to suspend non-earner or caregiver benefits because it failed to properly notify the applicant or put her to an election.

The insurer was awarded $1,000 in expenses.