Allan W. Chapnik

The applicant was injured in a motor vehicle accident and received income replacement benefits until they were terminated by the insurer.

The applicant brought a motion for interim benefits pending the arbitration hearing and sought production of the insurer's claims file.

The arbitrator found that the applicant failed to attend a scheduled insurer examination, entitling the insurer to suspend benefits for that period.

The arbitrator dismissed the motion for interim benefits, finding the applicant had not established a prima facie case for entitlement given the conflicting medical evidence and lack of cross-examination.

The arbitrator also made several production orders, requiring the applicant to produce medical records from one year pre-accident and the insurer to produce non-privileged portions of its claims file.

The applicant sought interim income replacement benefits after the insurer terminated them.

The arbitrator found that the insurer's termination of benefits was based on a flawed Designated Assessment Centre (DAC) process, which failed to comply with section 64 of the Statutory Accident Benefits Schedule.

The arbitrator also found that the applicant established a strong prima facie case for entitlement to benefits and demonstrated financial urgency.

The insurer was ordered to pay interim benefits of $313.77 per week, with the issues of a special award and expenses reserved for the main arbitration hearing.