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Arbitrator orders new catastrophic impairment assessment after finding original DAC report fundamentally flawed for lacking a psychologist.
The self-represented applicant sought a catastrophic impairment designation following a motor vehicle accident.
The insurer denied the claim based on a Designated Assessment Centre (DAC) report.
In an interim decision, the arbitrator found that the DAC assessment was fundamentally flawed because it lacked a mandatory psychological assessor and failed to properly assign impairment ratings for all conditions, including fibromyalgia.
The arbitrator ordered that the applicant be given the option to undergo a new, properly constituted multidisciplinary assessment, or proceed to a final hearing based on the existing evidence.
Arbitration dismissed as vexatious after WSIAT ruled applicant was in the course of employment.
The applicant was injured in a motor vehicle accident.
The insurer denied statutory accident benefits on the basis that the applicant was in the course of his employment and covered by the Workplace Safety and Insurance Act (WSIA).
The insurer successfully applied to the Workplace Safety and Insurance Appeals Tribunal (WSIAT) under s. 31 of the WSIA, which determined the applicant had no right of action.
The insurer then moved to dismiss the FSCO arbitration as frivolous and vexatious under Rule 68 of the Dispute Resolution Practice Code.
The arbitrator granted the motion, finding that since the applicant had no right to sue, he could not claim accident benefits, and his failure to participate rendered the proceeding vexatious.
Insurer's claim for expenses dismissed due to its failure to properly inform applicants of dispute procedures.
The applicants were injured in a motor vehicle accident and applied for statutory accident benefits.
The insurer took the position that the applicants were in the course of their employment and therefore only entitled to workers' compensation benefits.
The applicants eventually withdrew their applications for arbitration.
The insurer sought its expenses under section 282(11) of the Insurance Act, arguing the proceedings were frivolous and vexatious.
The arbitrator dismissed the insurer's claim for expenses, finding that the insurer failed to provide the applicants with complete and correct information about the interaction between the Statutory Accident Benefits Schedule and the Workplace Safety and Insurance Act, 1997, and the proper dispute resolution procedures.
Arbitrator allows accident benefits claim to proceed despite premature application for mediation.
The Applicants were injured in a motor vehicle accident and applied for statutory accident benefits.
The insurer denied several claims.
The insurer brought a preliminary issue motion arguing that the FSCO Arbitration Unit lacked jurisdiction because the Applicants applied for mediation before the insurer had denied the claims, in breach of Rule 12.1 of the Dispute Resolution Practice Code.
The Arbitrator dismissed the motion, finding that while the Applicants breached the procedural rule, the statutory preconditions under section 50 of the Schedule and section 281(2) of the Insurance Act were met by the time the mediation actually occurred.
The Applicants were permitted to proceed to arbitration.
Appellants not required to pay for duplicate appeal transcripts; court reporters ordered to provide electronic copies for nominal fee.
The appellants, who were committed for trial on charges of first degree murder, appealed the dismissal of their applications to quash the committal order.
They brought a motion seeking an order that they not be required to pay for additional copies of the preliminary inquiry transcripts for the appeal, having already paid for copies used in the Superior Court.
They also sought an order requiring the court reporters to produce the transcripts on diskette for a nominal fee.
The Court of Appeal granted the motion, finding that rule 8(7) of the Criminal Appeal Rules is intended to avoid unnecessary duplication of expense, and ordered the court reporters to produce the transcripts on diskette for $1 each.
Insurer awarded full expenses after applicant's wilful misrepresentation and abuse of process prolonged arbitration.
Following a decision denying the applicant's claim for statutory accident benefits, both parties sought their expenses for the arbitration.
The arbitrator found that the applicant had engaged in wilful misrepresentation, delayed the resolution of the matter, and abused the tribunal's process.
Consequently, the applicant was denied his expenses.
The insurer was awarded its full claimed expenses of $14,960.76, as the applicant's conduct unnecessarily prolonged and obstructed the proceedings.
Accident benefits denied and repayment ordered where insured wilfully misrepresented claims by concealing subsequent accident.
The applicant sought statutory accident benefits, including income replacement and supplementary medical expenses, following a motor vehicle accident.
The insurer terminated benefits and sought repayment, alleging wilful misrepresentation due to the applicant's failure to disclose multiple other motor vehicle accidents and pre-existing injuries.
The arbitrator found the applicant to be an unreliable historian and concluded he failed to prove that his ongoing complaints were caused by the subject accident or that they prevented him from working.
The claims for benefits and a special award were dismissed.
The arbitrator ordered the applicant to repay all benefits received after a subsequent undisclosed accident, finding his failure to report it constituted wilful misrepresentation.
The insurer's request for an assessment against the applicant for a frivolous arbitration was denied.