Kadey BJ Schultz

The applicant sought reconsideration of a decision finding that the parties did not reach a binding settlement agreement.

The applicant argued the Tribunal acted outside its jurisdiction, breached procedural fairness, made errors of law and fact, and exhibited a reasonable apprehension of bias.

The adjudicator dismissed the request, finding no jurisdictional error, no breach of procedural fairness, and no errors in interpreting Regulation 664 or applying the legal test for settlement.

The adjudicator also rejected the allegation of bias, noting it was raised after the fact without cogent evidence.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied an award and costs.

The applicant argued the Tribunal violated procedural fairness by allowing the respondent to submit case law after the hearing closed, demonstrated bias, and misinterpreted sections of the Statutory Accident Benefits Schedule.

The adjudicator dismissed the reconsideration, finding that the late case law was not relied upon in the original decision, the bias allegation was unsubstantiated, and the applicant was merely attempting to re-litigate the original findings.

The applicant sought a special award under section 10 of Regulation 664, alleging the respondent unreasonably withheld or delayed payment of income replacement benefits (IRBs) following a motor vehicle accident.

The Tribunal found that the initial delay was due to the applicant's failure to provide necessary financial documentation, particularly given her self-employment status.

The Tribunal also found that the respondent's subsequent error in calculating the IRBs based on net rather than gross income, which was later corrected with interest, did not amount to excessive, imprudent, or stubborn conduct.

Both parties' requests for costs were dismissed.

The applicant was injured when she fell from and was trampled by her horse after it was spooked by an oncoming ATV and became stuck in a muddy ditch.

The insurer denied accident benefits, arguing the incident was not an 'accident' under the Schedule because the mud or an 'assault' by the horse broke the chain of causation.

The arbitrator applied the Chisholm and Greenhalgh tests, finding that the ATV was the active, efficient cause that set the events in motion.

The arbitrator concluded the incident was an accident, as the horse's reaction and the muddy ditch were normal risks associated with the ATV passing on a narrow rural road.

The appellant, a paralegal representative, appealed an arbitrator's order requiring him to personally pay the insurer's legal expenses of $2,910.41.

The arbitrator found that the appellant had commenced an arbitration proceeding for statutory accident benefits without the insured's authority, constituting an abuse of process.

On appeal, the appellant argued the arbitrator lacked jurisdiction to award costs against him once he was removed from the record.

The Director's Delegate dismissed the appeal, holding that section 282(11.2) of the Insurance Act applies to anyone who represented or purported to represent a party at some point in the proceeding, and that the arbitrator also had residual power under section 23(1) of the Statutory Powers Procedure Act to prevent abuse of process.

The insurer sought an assessment of expenses after an arbitrator previously ordered a paralegal to personally pay the insurer's expenses for commencing an unauthorized arbitration on behalf of the applicant.

The insurer claimed expenses on a substantial indemnity basis.

The arbitrator found that she lacked the authority to award expenses on a substantial indemnity basis under the Insurance Act or the Statutory Powers Procedure Act, as costs are limited to Legal Aid rates under the Dispute Resolution Practice Code.

The insurer's expenses were assessed and ordered to be paid by the paralegal in the amount of $2,910.41.

An arbitration application was submitted to the Financial Services Commission of Ontario in the applicant's name by a paralegal firm.

The applicant later stated he had not authorized the proceeding.

The insurer sought its expenses for responding to the unauthorized application.

The arbitrator found that the paralegal commenced the proceeding without the applicant's authority and caused the insurer to incur expenses without reasonable cause.

The application was withdrawn, and the paralegal was ordered to personally pay the insurer's expenses pursuant to section 282(11.2) of the Insurance Act.

The applicant sought statutory accident benefits for housekeeping and home maintenance expenses following a motor vehicle accident.

The insurer argued the applicant was precluded from claiming the benefits due to a failure to provide timely notice and particulars, and disputed the entitlement on the merits.

The arbitrator found that the delay in providing particulars did not bar the claim, as the remedy for such a breach is a delay in payment, not forfeiture.

However, the arbitrator dismissed the claim on the merits, finding the applicant and her witness lacked credibility due to numerous inconsistencies, fabricated evidence, and poor recall.

The applicant failed to prove the expenses were reasonable and necessary.

The applicant, who suffered a brain injury in a motor vehicle accident, applied for arbitration regarding statutory accident benefits.

Two preliminary issues were raised: whether the applicant had the capacity to instruct counsel and conduct the arbitration without a litigation guardian, and whether her 'facilitator' could participate in the proceedings.

The arbitrator found that the applicant possessed the requisite capacity to direct her arbitration and make decisions, including the choice to self-represent.

However, the arbitrator ruled that the facilitator could not appear as an agent, representative, translator, or party, as she was performing the role of an unregistered representative for compensation and had a conflict of interest due to her financial stake in the outcome.

The appellant was injured in a motor vehicle accident and claimed income replacement benefits based on self-employment.

The insurer requested corporate documentation, which the appellant delayed in providing.

At a preliminary hearing, the Arbitrator found the appellant failed to comply with reasonable requests for information and ordered her disentitled to benefits for the period of non-compliance pursuant to section 33(2) of the SABS-1996.

On appeal, the Director's Delegate held that section 33(2) authorizes a delay or suspension of benefits, not a permanent forfeiture.

The Delegate also found the Arbitrator erred in treating the preliminary order as a final dismissal of the claim for that period.

The appeal was allowed and a new arbitration hearing was ordered.

The applicant sought to withdraw her arbitration regarding statutory accident benefits after a preliminary issue decision found her disentitled to certain income replacement benefits for failing to provide reasonably required information under section 33 of the Schedule.

The insurer objected unless conditions were imposed.

The arbitrator allowed the withdrawal on the condition that the applicant pay the insurer's reasonable expenses for the hearing, pay the assessment fee if she recommences the arbitration, and that interest on outstanding benefits be suspended.

The arbitrator also ordered the applicant to pay the insurer's expenses for the second day of the preliminary hearing because she decided not to testify at the last minute, causing unnecessary expense.

The applicant was injured in a motor vehicle accident and applied for income replacement benefits.

The insurer requested corporate financial information and source documentation to calculate the benefits, as the applicant was self-employed through a closely-held corporation.

The applicant failed to provide the requested information in a timely manner and provided no reasonable explanation for the delay.

The arbitrator found that the applicant breached section 33 of the Statutory Accident Benefits Schedule and was disentitled to income replacement benefits beyond the minimum rate of $185 per week for the period of non-compliance.