Kevin Griffiths

The applicant applied for statutory accident benefits following an alleged motor vehicle accident.

The insurer denied the benefits on the basis that the accident was staged.

The applicant's representative brought a motion to withdraw due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the arbitration hearing despite being properly served with notice.

The arbitrator granted the representative's motion to withdraw and proceeded with the hearing in the applicant's absence.

As the applicant presented no evidence, the application for arbitration was dismissed, and the applicant was ordered to pay the insurer's arbitration expenses.

The Ontario Trial Lawyers Association (OTLA) brought a motion for leave to intervene as a friend of the court in an application for judicial review concerning the interpretation of catastrophic impairment.

The applicant opposed the motion, arguing OTLA's interest was indirect and the case involved straightforward statutory interpretation.

The court granted the motion, finding that OTLA had expertise, could provide a broader perspective on the legislative scheme, and its participation would not prejudice the parties.

Leave to intervene was granted subject to conditions.

The insurer brought a motion to strike out the insured's claim for a special award prior to the arbitration hearing.

The insurer argued that because all income replacement benefits had been paid and none were outstanding at the time the application for arbitration was filed, a special award could not be granted under section 282(10) of the Insurance Act.

The arbitrator dismissed the motion, finding that the legislation mandates a special award where payments are unreasonably delayed, and that a literal interpretation requiring benefits to be outstanding at the time of the award would lead to an absurdity contrary to the consumer protection mandate of the accident benefits scheme.

The arbitrator concluded it was not plain and obvious that the claim for a special award would fail.

The applicant was injured in a pedestrian motor vehicle accident and sought a determination that she suffered a catastrophic impairment under the Statutory Accident Benefits Schedule.

The arbitrator found that while the applicant's combined physical and psychological impairments resulted in a 39% whole person impairment, falling short of the 55% threshold under clause (f), she did meet the criteria under clause (g).

Specifically, the arbitrator accepted the CAT DAC assessment that the applicant's pain disorder and physical limitations resulted in a Class 4 marked impairment in her activities of daily living.

The arbitrator held that a single marked impairment is sufficient to meet the definition of catastrophic impairment.

The applicant, injured in a motor vehicle accident, sought income replacement benefits and requested that the insurer disclose whether it had conducted surveillance and, if so, produce it 90 days before the hearing.

The insurer refused to disclose whether surveillance existed and offered to produce any relied-upon surveillance 60 days prior.

The arbitrator ordered the insurer to promptly disclose whether surveillance had been conducted and, if it intended to rely on any surveillance, to produce it 90 days before the hearing to allow the applicant sufficient time to respond with medical evidence without incurring undue financial burden under the Dispute Resolution Practice Code.

The Applicant sought leave to withdraw her application for arbitration regarding the termination of her caregiver benefits, preferring to pursue the matter in Superior Court alongside a pending tort action.

The Insurer did not oppose the withdrawal but argued it should be allowed to proceed with its claim for repayment of benefits and a preliminary issue hearing on whether the Applicant was actually involved in the accident.

The Arbitrator granted the Applicant leave to withdraw, subject to resolving expenses.

The Arbitrator dismissed the Insurer's claim for repayment without prejudice, finding that the Commission lacks jurisdiction to hear a free-standing claim by an insurer when the applicant has withdrawn all issues from arbitration.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for Botox treatment for chronic pain and cervicogenic headache.

The insurer denied the treatment plan on the basis that the use of Botox for these conditions was experimental in nature.

At the arbitration hearing, the arbitrator weighed competing expert medical evidence regarding the efficacy and acceptance of Botox for chronic pain.

The arbitrator preferred the evidence of the applicant's expert, finding that the treatment is becoming an accepted therapy and is no longer experimental.

The arbitrator ordered the insurer to pay for the treatment and awarded expenses to the applicant.

The applicant attended a pre-hearing discussion for a statutory accident benefits dispute, having travelled from Sarnia and taken a day off work.

The insurer's representative failed to attend for personal reasons, but the insurer failed to provide advance notice to the applicant.

The arbitrator found that the applicant incurred needless expenses due to the lack of notice and awarded $300 in expenses to the applicant.

The appellant appealed an arbitrator's decision finding that he did not suffer a catastrophic impairment as a result of a motor vehicle accident.

The appellant argued that the arbitrator erred in law by failing to order a new Catastrophic Impairment Designated Assessment Centre (CAT DAC) assessment after recognizing serious procedural flaws in the original DAC process, including the omission of his treating neurosurgeon's report and the failure to conduct a clinical assessment.

The Director's Delegate dismissed the appeal, holding that while there were substantial departures from the DAC Guidelines, the arbitrator had the authority and discretion to weigh the DAC report alongside all other evidence and was not required to order a new assessment.

Following a preliminary issue hearing where the insurer was successful in establishing that the applicant was not catastrophically impaired, the arbitrator determined the issue of arbitration expenses.

The arbitrator awarded the applicant 20% of his expenses, noting that while the insurer was successful on the principal issue, the applicant succeeded on secondary issues and the insurer failed to meaningfully participate in settlement discussions.

The applicant was awarded $3,047.89 in expenses.

The applicant was injured in a motor vehicle accident and claimed housekeeping benefits, acupuncture treatment, and a special award.

The arbitrator found the applicant was entitled to $3,676 for housekeeping expenses, as she suffered a substantial inability to perform her household tasks for a period following the accident.

The claim for further acupuncture treatment was denied because the medical evidence emphasized regular exercise rather than passive therapies.

The claim for a special award was dismissed as the insurer's denial of benefits was supported by an expert opinion and was not unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident.

During the arbitration process, the insurer failed to have a representative attend a mandated pre-hearing discussion, resulting in the discussion being rescheduled.

The applicant sought $125 for expenses thrown away due to the adjournment.

The arbitrator found that the insurer's failure to have a principal participate frustrated the purpose of the pre-hearing discussion and ordered the insurer to pay $125 in legal expenses pursuant to subsection 282(11.1) of the Insurance Act.