Jonathan B. Schrieder

The Insurer sought its expenses following an arbitration hearing where the Applicant's claims for statutory accident benefits were either withdrawn or dismissed.

The Applicant argued that the Insurer's conduct prolonged the proceeding and that the claimed costs were excessive.

The Arbitrator found that the Insurer was entirely successful and entitled to expenses.

Applying a 3:1 ratio for preparation to hearing time and reducing excessive disbursements, the Arbitrator fixed the Insurer's expenses at $12,070.91 and ordered the Applicant to pay this amount.

The appellant insurer appealed an arbitration decision awarding statutory accident benefits and a special award to the respondent.

The appellant failed to provide the required arbitration transcripts, ignored multiple communications from the appeals office, and abruptly attempted to withdraw the appeal without following proper procedures.

The Director's Delegate found that the appellant's course of conduct demonstrated a willful disregard for the appeal process and that the appeal was commenced in bad faith.

The appeal was dismissed without a hearing pursuant to Rule 68.1 of the Dispute Resolution Practice Code.

In a motor vehicle personal injury action, the plaintiff sought an order compelling the tortfeasor’s insurer, added as a statutory third party after denying coverage, to answer written interrogatories and deliver an affidavit of documents explaining the basis for its denial of coverage.

The information was sought to determine whether the insurer’s liability was reduced to the statutory minimum by operation of law, which would affect the plaintiff’s entitlement to underinsured coverage under the OPCF 44R endorsement from his own insurer.

The court held that the facts underlying the denial of coverage were relevant to the plaintiff’s claim for underinsured motorist coverage and fell within the rationale of Rule 31.06(4) concerning disclosure of insurance and conditions affecting its availability.

The statutory third party insurer could not refuse discovery wholesale on the basis of privity or potential prejudice, though it could raise privilege or prejudice objections on a question‑by‑question basis.

The court ordered the insurer to answer the interrogatories and produce a sworn affidavit of documents.

The appellant insurer appealed an arbitrator's decision awarding the respondent income replacement benefits (IRBs) and housekeeping and home maintenance benefits following a motor vehicle accident.

The Director's Delegate allowed the appeal in part.

The Delegate found the arbitrator erred in law by awarding IRBs for a period prior to September 3, 2010, as there was no evidence of a shortfall, and reduced the IRB award accordingly.

The Delegate also rescinded the housekeeping benefits award because the arbitrator decided entitlement for a period not in dispute.

The appeal regarding arbitration legal expenses was dismissed as the arbitrator had not yet made a formal order on expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, attendant care, and housekeeping benefits.

The arbitrator found the applicant's testimony lacked credibility due to inconsistencies and failure to disclose a subsequent accident to medical assessors.

However, relying on objective medical evidence, the arbitrator concluded the applicant suffered a substantial inability to perform his pre-accident employment as a cleaner for the first 104 weeks.

The applicant did not meet the complete inability test for the period after 104 weeks.

The arbitrator awarded income replacement benefits for the initial period, subject to deductions for post-accident earnings, and granted attendant care and housekeeping benefits for a limited period.

Following a mixed result in a statutory accident benefits arbitration, the parties sought their expenses.

The arbitrator reviewed the criteria under Rule 75.2 of the Dispute Resolution Practice Code.

Finding that each party was partially successful and that neither party's conduct unduly prolonged the proceeding, the arbitrator ordered that each party bear its own expenses.

The applicants applied for statutory accident benefits following a motor vehicle accident.

After mediation failed, they applied for arbitration but subsequently failed to pursue their claims, instruct counsel, or attend pre-hearings and the scheduled arbitration hearing.

The arbitrator dismissed the applications for arbitration without a hearing under Rule 68 of the Dispute Resolution Practice Code due to abandonment.

The insurer was awarded $1,500 in expenses because the applicants' conduct unnecessarily prolonged the proceedings.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The matter proceeded to an arbitration hearing.

The applicant's representative successfully moved to be removed from the record.

The applicant failed to attend the hearing.

The insurer brought a motion to dismiss the application.

The arbitrator dismissed the application for arbitration due to the applicant's failure to appear and discharge her burden of proof.

The insurer was awarded its expenses of the arbitration, with the quantum to be determined at a subsequent assessment hearing.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement, attendant care, housekeeping, and medical benefits.

The arbitrator found the applicant lacked credibility, noting numerous contradictions and inconsistencies in his testimony and medical evidence.

The applicant had resumed working as a personal fitness trainer and participating in bodybuilding competitions during the period he claimed to be disabled.

The claims for income replacement, attendant care, and housekeeping benefits were dismissed due to a lack of credible evidence.

However, the arbitrator approved one treatment plan for $3,510.00 and the cost of an MRI for $569.80, finding them reasonable and necessary based on the credible testimony of the treating chiropractor.

The applicant, a pedestrian struck by a motor vehicle, sought statutory accident benefits including housekeeping, attendant care, and income replacement benefits.

The arbitrator dismissed the claim for housekeeping benefits as the insurer had already paid the amount claimed.

The arbitrator awarded attendant care benefits for the period before the applicant submitted the required Form 1, finding it was submitted within a reasonable time.

The claim for ongoing income replacement benefits was dismissed because the medical evidence, including reports from the applicant's own assessors, and the applicant's unreliable testimony failed to establish a substantial inability to perform the essential tasks of her pre-accident employment.

The applicant sought his expenses of the arbitration after being granted income replacement benefits but denied other claims.

The insurer sought reimbursement of its expenses, arguing the applicant prolonged and obstructed the process.

The arbitrator found no evidence of delay or obstruction by the applicant and noted his modest success entitled him to a modest recovery of expenses.

The arbitrator applied a ratio method to reduce the claimed legal fees and disallowed or reduced several disbursements, including rejecting an expert report that violated the expert's duty to the Tribunal.

The insurer was ordered to pay the applicant $18,918.77 for his arbitration expenses.

The applicant was injured in a motor vehicle accident and claimed non-earner benefits.

At the time of the accident, he was receiving an Ontario Disability Support Program (ODSP) benefit.

The insurer argued it was entitled to deduct the ODSP benefit from the non-earner benefit as a collateral benefit under section 60 of the Schedule.

The arbitrator held that section 58 of the Schedule requires insurers to pay benefits despite the receipt of ODSP benefits, and that ODSP regulations require the inclusion of non-earner benefits in income, thereby avoiding double compensation.

The insurer was ordered to pay the full non-earner benefit without deduction.

The applicant applied for arbitration regarding statutory accident benefits following a motor vehicle accident.

The applicant's legal representative brought a motion to withdraw due to a breakdown in the solicitor-client relationship, which was granted.

The applicant failed to attend the arbitration hearing despite receiving proper notice.

Consequently, the arbitrator proceeded in the applicant's absence, dismissed the application for arbitration, and ordered the applicant to pay $1,500 in expenses to the insurer.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2007.

The arbitrator found the applicant's evidence to be unreliable due to poor recall and contradictions with documentary evidence, including Ontario Works records showing he had returned to work.

Relying on the medical evidence, particularly the applicant's orthopaedic surgeon, the arbitrator concluded the applicant suffered a complete inability to engage in suitable employment for a limited period.

The applicant was awarded income replacement benefits from July 7, 2009, to August 1, 2010, but his claims for various assessment costs and a special award were dismissed.

The applicant was seriously injured in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment due to a mental or behavioural disorder.

The insurer argued that her marked impairment was a manifestation of malingering or factitious disorder, pointing to an initial period of improvement followed by deterioration.

The arbitrator reviewed extensive medical and lay evidence, finding that the applicant's current presentation of severe depression, anxiety, and pain focus was a direct result of the accident.

The arbitrator rejected the insurer's allegations of malingering, noting the lack of pre-existing conditions and the consistency of the applicant's presentation over time.

The arbitrator concluded the applicant suffered a catastrophic impairment.

The applicant sought non-earner benefits (NEBs) following a motor vehicle accident.

The arbitrator found that the applicant did not qualify for an income replacement benefit as he was not employed at the time of the accident.

Applying the test for NEBs, the arbitrator concluded that the applicant did not suffer a complete inability to carry on a normal life, as he remained independent in self-care and was not completely unable to engage in housekeeping and home maintenance.

The application for NEBs, a special award, and interest was dismissed.

The applicant claimed lost educational expenses following a motor vehicle accident.

After her counsel was removed from the record, the applicant failed to attend the scheduled arbitration hearing.

As she provided no evidence to prove entitlement to the claimed benefits, the arbitrator dismissed the application and ordered the applicant to pay $750 in arbitration expenses to the insurer.

In an arbitration for statutory accident benefits, the insurer brought a motion seeking production of photographs and videos posted to the applicant's restricted Facebook account.

The insurer argued the images were relevant to the applicant's claim for income replacement and housekeeping benefits.

The arbitrator dismissed the motion, finding that the insurer failed to establish a reasonable relationship between the images and the issues to be arbitrated.

The arbitrator held that the potential relevance of social media images was too remote when weighed against the procedural burden, sensitivity, and practicality of producing them in an administrative tribunal context.

The applicant claimed lost educational expenses under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The applicant failed to attend the arbitration hearing, and the arbitrator initially proceeded and closed the hearing after refusing an adjournment.

However, upon realizing that the Commission had failed to provide the applicant with proper advance written notice of the hearing date, the arbitrator found that deciding the claim would violate due process.

The arbitrator ordered the hearing re-opened under Rule 43 of the Dispute Resolution Practice Code.

Following a preliminary issue hearing where the arbitrator determined the applicant had entered into a binding full and final settlement of all accident benefit claims, the insurer sought its expenses for the hearing.

The arbitrator considered the criteria under the Expense Regulation, noting the insurer's complete success and the lack of novel issues raised by the applicant's mistake argument.

The arbitrator found the insurer was entitled to its reasonable expenses and ordered the applicant to pay $2,366.33.