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Insurer awarded reduced expenses of $3,459.39 following successful preliminary issue hearing.
Following the dismissal of the applicant's application for arbitration on a preliminary issue, the insurer sought its expenses of the proceeding.
The arbitrator found the insurer was entitled to its expenses as the successful party.
The arbitrator reduced the insurer's claimed legal fees, finding the involvement of four lawyers and a law clerk for a straightforward limitation period issue to be excessive and duplicative.
The insurer was awarded $3,459.39 in total expenses, inclusive of fees, disbursements, and HST.
Slip and fall on ice after exiting vehicle is not an accident under the Schedule.
The applicant sought statutory accident benefits after slipping and falling on black ice in a parking lot.
She claimed she fell while exiting her vehicle and struck her head on the vehicle's step.
The insurer denied the claim, arguing the incident was not an "accident" under s. 3(1) of the Statutory Accident Benefits Schedule.
The arbitrator found the applicant's initial medical records did not mention her vehicle or hitting her head, and concluded she had safely exited the vehicle before slipping on the ice.
The arbitrator held that the ice was an intervening factor and the use or operation of the vehicle was not the direct cause of the impairment.
The application for arbitration was dismissed.
Arbitration application dismissed as time-barred because mediation was requested beyond the two-year limitation period.
The applicant was injured in a motor vehicle accident and sought caregiver and non-earner benefits.
The insurer denied the benefits and later raised a preliminary issue that the applicant was statute-barred from proceeding to arbitration because she failed to apply for mediation within the two-year limitation period.
The arbitrator found that the insurer provided a valid, clear, and unequivocal notice of stoppage of benefits, which triggered the limitation period.
Because the applicant applied for mediation more than three years after the denial, the application for arbitration was dismissed as time-barred.
Insurer awarded $6,950 in arbitration expenses after successfully defending a claim for caregiver benefits.
The insurer was entirely successful in an arbitration regarding the applicant's claim for weekly caregiver benefits.
The insurer sought its expenses of the arbitration proceeding under the Expense Regulation.
The arbitrator found that the insurer's complete success entitled it to its reasonable expenses.
Applying a 2:1 ratio for preparation to hearing time and allowing for one counsel, the arbitrator awarded the insurer $5,600.00 for fees and $1,350.00 for disbursements, for a total of $6,950.00 inclusive of HST.
Caregiver benefits denied because the applicant was not the primary caregiver for his children.
The applicant was injured in a motor vehicle accident and applied for weekly caregiver benefits, claiming he was the primary caregiver for his two young children.
The insurer denied the claim.
At arbitration, the evidence showed that while the applicant was an involved father, he worked full-time in a limousine business, whereas his wife was a full-time homemaker who handled the majority of day-to-day childcare tasks.
The arbitrator concluded that the applicant's wife, not the applicant, was the primary caregiver at the time of the accident.
As caregiver benefits are only available to the primary caregiver, the application was dismissed.
Contractor awarded reduced contract balance despite defective insulation overspray.
A contractor commenced an action to enforce payment of the balance owing under a contract for the supply and installation of polyurethane spray foam insulation at an industrial property.
The defendants refused payment alleging extensive overspray damage to equipment and asserting that the balance had been forgiven due to deficient workmanship.
The court found that significant overspray occurred and that the contractor’s workmanship was substandard, but rejected the alleged agreement to forgive the balance and found the defendants had continued using the equipment without remediation while preventing the contractor from attempting cleanup.
Applying a reasonable reduction to account for the deficiencies, the court awarded the contractor a reduced balance of the contract price and dismissed the defendants’ counterclaim.
The contractor was also granted a construction lien for the amount of judgment and partial indemnity costs.
