James D. Tomlinson

The applicant was injured in two motor vehicle accidents.

He received accident benefits from Allstate for the first accident and applied for benefits from Zurich for the second accident.

Zurich failed to respond to the arbitration application or pay the assessment fee, and the hearing proceeded without them.

Zurich later moved to re-open the hearing, citing inadvertence.

The arbitrator dismissed the motion to re-open, finding Zurich's conduct amounted to negligence and re-opening would prejudice the applicant.

The arbitrator awarded the applicant weekly income benefits of $185.60 and medical/rehabilitation benefits of $1,649.80 based on his uncontested evidence.

The claim for a special award was dismissed as there was insufficient evidence to find Zurich acted unreasonably beyond its failure to participate.

The Applicant was injured in a motor vehicle accident and received caregiver benefits for her elderly mother, who resided with her at the time of the accident.

The mother subsequently suffered a stroke and was moved to a nursing home, ceasing to reside with the Applicant.

The Insurer terminated the caregiver benefits on the basis that the mother no longer resided with the Applicant.

The Arbitrator held that under the plain meaning of sections 13(4) and 13(6) of the No-Fault Benefits Schedule, the requirement to reside together applies only at the time of the accident, and none of the termination conditions in section 13(6) applied.

The Insurer was ordered to continue paying the caregiver benefits.