Kenneth Arenson

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits, asserting he was a successful self-employed jewellery manufacturer.

The insurer paid the maximum weekly income benefit of $600 based on a purported purchase order.

The arbitrator found that the applicant had fraudulently misrepresented the status of his business and the existence of the purchase order, and that the insurer had erred in calculating benefits based on anticipated rather than earned income.

The applicant was found to be self-employed but only entitled to the minimum weekly benefit of $185.60 for 156 weeks.

The insurer was awarded a repayment of $21,446.40 for the overpayment.

Claims for benefits beyond 156 weeks and a special award were dismissed.

The applicant was injured in a motor vehicle accident and sought reinstatement of weekly income benefits, arguing she was on a 'temporary lay-off' from her work as a real estate salesperson and thus entitled to benefits under section 12 of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant had resigned from her position 15 months prior to the accident, actively sought other employment, and was therefore unemployed rather than on a temporary lay-off.

The claim for interim benefits was also denied due to a lack of medical evidence.

The applicant's entitlement to benefits will be considered under section 13 of the Schedule at a continuation of the hearing.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until they were terminated by the insurer.

The applicant applied for arbitration to determine her ongoing entitlement to weekly benefits and whether they should be calculated under section 12 or 13 of the Schedule.

The insurer brought a motion to include the issues of repayment of overpaid benefits and the deductibility of CPP and Old Age Pension benefits.

The arbitrator dismissed the insurer's motion, finding that the insurer's proposed issues did not naturally or consequentially flow from the matters referred to arbitration by the applicant.

The Applicant was injured in a motor vehicle accident and claimed expenses for a Health Care Aide to assist her at home, arguing these were 'nursing services' under section 6(1)(a) of the Statutory Accident Benefits Schedule, which has no monthly limit.

The Insurer argued the services were 'care' benefits under section 7, subject to a $3,000 monthly limit.

The Arbitrator held that the services provided by the Health Care Aide were best described as 'care' rather than 'nursing services,' as they were primarily focused on assisting with daily tasks rather than active treatment or rehabilitation.

Therefore, the benefits were limited to $3,000 per month under section 7.

The applicant, a Manitoba resident, was injured in a motor vehicle accident in Ontario while driving a vehicle insured by the Saskatchewan Government Insurance Office (SGIO).

The applicant applied for no-fault benefits under the Ontario Insurance Act, but SGIO refused to pay, arguing it was not liable under Saskatchewan law.

The arbitrator held that SGIO was bound by a Power of Attorney and Undertaking it had signed, which precluded it from setting up a defence that would not be available to an Ontario insurer.

Consequently, SGIO was found liable to pay no-fault benefits to the applicant.