Gary Spector

The insurer brought a preliminary motion seeking an order for the production of various medical, employment, and financial records by a specific date, failing which the arbitration would be stayed.

The arbitrator found that the requested documents were relevant but were largely in the possession of third parties and not within the applicant's control.

The arbitrator declined to stay the proceedings, instead accepting the applicant's representative's undertaking to forward production request letters to the third parties, copied to the insurer, within 30 days.

The applicant sought interim income replacement benefits following a motor vehicle accident.

The insurer had terminated her benefits, and the applicant argued she was entitled to interim benefits based solely on financial need and the insurer's defective termination notice.

The arbitrator dismissed the motion, holding that the test for interim benefits requires both financial urgency and a prima facie case for entitlement based on health.

Because the applicant elected to proceed without providing medical evidence, she failed to establish a prima facie case.

The arbitrator also rejected the argument that a defective termination notice created a positive obligation to pay benefits on the merits.

The applicants were injured in a motor vehicle accident and sought medical benefits.

The insurer refused the treatment plans and required a Designated Assessment Centre (DAC) assessment.

The applicants requested to reschedule the assessment due to work conflicts, but the DAC and insurer refused.

The insurer then denied benefits, claiming the applicants failed to make themselves reasonably available for the assessment.

On a preliminary issue motion, the arbitrator found that the applicants' request to reschedule was reasonable and that the insurer and DAC acted unreasonably in refusing to accommodate them.

The insurer's motion to bar the arbitration was denied.

The insurer appealed a preliminary arbitration decision finding that the insured was not disentitled to weekly income benefits under section 16(2) of the Schedule, as she had not worked for a continuous period of 90 days after the two-year anniversary of the accident.

The insured appealed a subsequent arbitration decision finding she was no longer eligible for weekly income benefits under section 12(1).

The Director's Delegate dismissed both appeals, upholding the arbitrator's interpretation of section 16(2) as referring to continuous periods of work, and finding no error in the arbitrator's evaluation of the evidence regarding the insured's eligibility.

The insurer was ordered to pay the insured's expenses for the preliminary issue appeal, but no expenses were awarded for the eligibility appeal.

The Applicant was injured in a motor vehicle accident and received weekly income benefits until they were terminated by the Insurer.

The Insurer raised a preliminary issue that the Applicant was no longer eligible for benefits under section 16(2) of the Schedule because she had returned to work for an aggregate of more than 90 days after the second anniversary of the accident.

The Arbitrator held that the phrase 'for periods of up to ninety days' in section 16(2) means one or more continuous periods of up to 90 days each, not an aggregate of shorter periods.

Since the Applicant had not worked for a continuous period of 90 days, she remained eligible for benefits.