Jonathan B. Schrieder

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The Delegate also rescinded the housekeeping benefits award because the arbitrator decided entitlement for a period not in dispute.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 Applicants claimed statutory accident benefits following a motor vehicle accident.

At the arbitration hearing, the Applicants failed to attend.

Their representative requested and was permitted to withdraw due to a breakdown in the representative-client relationship.

As the Applicants presented no evidence to establish their entitlement to the benefits claimed, their claims were dismissed.

The Applicants were ordered to pay $1,500 each toward the Insurer's arbitration expenses.

Following the dismissal of the applicant's claims in an arbitration proceeding, the insurer sought its expenses.

The arbitrator found the insurer was completely successful and entitled to its expenses.

The insurer claimed $16,587.10, but the arbitrator found the hours claimed excessive for a simple two-day hearing with only two witnesses.

Applying Legal Aid rates and a 1:1 preparation-to-hearing ratio, the arbitrator fixed the insurer's expenses at $5,300.00, inclusive of fees, disbursements, and taxes.

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

The matter proceeded to an arbitration hearing, but the applicant failed to attend.

At the hearing, the applicant's representative brought a motion to be removed from the record, citing an inability to contact his client.

The arbitrator denied the motion, finding that the representative forfeited the right to withdraw by waiting until the hearing itself without extenuating circumstances.

The insurer requested that the applicant's claims be dismissed due to his non-attendance.

The arbitrator dismissed the claims, noting the applicant failed to provide evidence to support his case, and awarded expenses to the insurer.

The original arbitrator commenced a hearing but did not complete it.

A pre-hearing discussion was held to determine how to proceed.

The parties agreed that the hearing should be recommenced de novo.

The new arbitrator ordered that the hearing be reheard from the beginning, that the new arbitrator not be given a copy of the transcript of the incomplete hearing, and that the insurer not be permitted to use or introduce any part of the transcript in the rehearing.

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

The insurer terminated these benefits after approximately one year based on insurer examinations finding no objective evidence of impairment.

The arbitrator dismissed all of the applicant's claims, finding the applicant lacked credibility due to his failure to disclose a significant pre-accident history of chronic pain to his assessors and his family doctor.

The arbitrator gave little weight to the applicant's medical expert, whose opinion relied entirely on the applicant's subjective and unreliable history.

The applicant was injured in a motor vehicle accident and claimed attendant care benefits for services provided by her two daughters.

The insurer denied the claim, arguing the expenses were not 'incurred' under s. 3(7)(e) of the Statutory Accident Benefits Schedule because the daughters did not suffer an economic loss.

The arbitrator found that the daughters did suffer an economic loss by renting an apartment and paying household expenses to support the applicant during her convalescence.

The applicant was awarded attendant care benefits, but her claim for a special award was dismissed as the insurer's denial was not unreasonable given the justiciable issue of economic loss.

The applicant's representative brought a motion to withdraw as counsel of record due to an inability to contact or receive instructions from the applicant since a pre-hearing discussion.

The insurer brought a cross-motion to compel production of agreed-upon documents.

The arbitrator granted the representative's motion to withdraw on the condition that all outstanding productions in the representative's possession be provided to the insurer, and any future documents received from prior requests be forwarded.

The issue of expenses was deferred to the hearing arbitrator.

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

The matter proceeded to an arbitration hearing, but neither the applicant nor a representative attended.

As the applicant bore the burden of proof and failed to present any evidence or representations, the arbitrator dismissed the application for lack of participation.

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.