Gordon Lee

The insurer brought a motion for the production of various documents and information from the applicant in a dispute over income replacement benefits.

The applicant argued that the test for production at FSCO should be strict 'relevance' rather than 'semblance of relevance', relying on recent amendments to the Rules of Civil Procedure.

The arbitrator rejected this argument, holding that the 'semblance of relevance' test and a broad stroke approach to production remain the standard at FSCO, subject to considerations of proportionality and privilege.

The arbitrator ordered the applicant to produce her CPP and disability files, income tax returns, ODSP file, educational history, and employment file, but denied the request for health care and collateral coverage plans.

The appellant appealed an arbitrator's decision dismissing his claims for income replacement benefits, housekeeping expenses, and medical and rehabilitation expenses following a 1997 motor vehicle accident.

The appellant argued that the insurer's failure to provide proper notice under sections 37 and 49 of the Schedule entitled him to automatic reinstatement of benefits, and that the arbitrator made numerous errors of fact and law, including ignoring medical evidence and demonstrating bias.

The Director's Delegate dismissed the appeal, holding that inadequate notice does not automatically entitle an insured to benefits, and that the arbitrator's findings of fact regarding the appellant's lack of credibility and failure to meet the disability tests were supported by the evidence.

The Delegate also found no reasonable apprehension of bias and affirmed that appeals under section 283(1) of the Insurance Act are restricted to questions of law.

The claimant was injured in a motor vehicle accident and sought statutory accident benefits.

The insurer raised the preliminary issue of the claimant's mental capacity to proceed with the arbitration.

The arbitrator found that the claimant lacked the mental capacity to proceed in the dispute resolution process, relying on psychiatric evidence of severe attention deficit disorder and the claimant's demonstrated inability to understand the proceedings.

The arbitrator declared the claimant a party under disability and directed the matter to the Public Guardian and Trustee.