Joseph Pileggi

The applicant, who sustained a severe closed head injury in a motor vehicle accident, brought a motion to add issues to an upcoming arbitration hearing regarding statutory accident benefits.

The proposed additional issues concerned estate management expenses and out-of-pocket travelling expenses for family members.

The arbitrator dismissed the motion, finding that adding the complex estate management issues so close to the hearing date would prejudice the insurer.

The arbitrator also refused to add the travelling expenses issue because it had not been formally mediated, which is a statutory prerequisite under the Insurance Act.

The Applicant was injured in a motor vehicle accident while receiving WSIB benefits for a prior workplace injury.

She applied for income replacement benefits (IRBs) from her auto insurer, claiming she had a prospective contract of employment to return to her pre-injury job once physically fit.

The Arbitrator found that her return to work was entirely contingent on her being physically capable of performing her pre-injury duties, which constituted a true condition precedent that was not satisfied at the time of the accident.

The Arbitrator concluded there was no reasonable prospect she would have returned to her prior employment within one year of the accident.

The claim for IRBs was dismissed.

The applicant, a minor who suffered severe injuries after being struck by a motor vehicle, applied for statutory accident benefits from two insurers.

Allstate paid benefits to date, while York Fire denied liability.

On a preliminary issue hearing, the arbitrator ordered both insurers to share equally in the payment of interim benefits pending the final arbitration to determine priority.

The arbitrator found jurisdiction to make interim orders under section 279(4.1) of the Insurance Act and held that the applicant established a prima facie case for entitlement and urgency.

The applicants, two young children severely injured in a motor vehicle accident, applied for statutory accident benefits.

A priority dispute arose between the father's former insurer and the insurer of the vehicle involved in the accident.

The father's former insurer claimed it had cancelled his policy for non-payment of premiums prior to the accident by sending a notice via registered mail.

The vehicle's insurer argued the cancellation was invalid because the notice was never received.

The arbitrator found that the former insurer had validly terminated the policy in accordance with the statutory requirements, as the notice was received at the destination post office in time to provide the required 15 days' notice.

Consequently, the vehicle's insurer was held responsible for paying the statutory accident benefits.