Jeffrey D. Puritt

The appellant was injured in a motor vehicle accident and sought payment for physiotherapy expenses from a private clinic.

The parties signed a settlement agreement releasing claims but requiring the insurer to pay expenses up to a certain date.

The insurer refused to pay the clinic's bill, arguing the treatment was reasonably available through OHIP.

The arbitrator dismissed the claim, finding she lacked jurisdiction to enforce the settlement.

On appeal, the Director's Delegate held that the arbitrator had jurisdiction to determine whether the settlement governed the benefits claimed and ordered the insurer to pay the clinic's fee pursuant to the settlement agreement.

The applicant sought her expenses for an arbitration hearing regarding a claim for physiotherapy expenses, which had been dismissed.

The arbitrator denied the applicant's request for expenses, finding that her claim was unmeritorious, misguided, and that her conduct during the hearing, including a baseless bias application, unreasonably prolonged the proceedings.

However, the arbitrator ordered the insurer to pay $1,000 in expenses due to its failure to produce documents in a timely fashion.