Paul A. Gemmink

Following a successful appeal by the insurer regarding the arbitrator's jurisdiction over a settlement enforcement proceeding, both parties sought their expenses of the arbitration and appeal.

The Director's Delegate declined to award expenses to either party, finding that although the insurer was entirely successful on appeal, the issues raised regarding the application of the method of payment rules to settlement funds were novel and the arbitration proceeding was not improper.

The parties were ordered to bear their own expenses.

The insured's agent misappropriated a $15,000 settlement cheque mailed to the agent by the insurer.

The insured's estate sought arbitration, arguing the insurer breached section 44(1)(a) of the Statutory Accident Benefits Schedule by not delivering the cheque directly to the insured.

The Arbitrator agreed, but on appeal, the Director's Delegate revoked the order.

The Delegate held that section 44 governs the payment of benefits, not lump-sum settlement payments, and that the Commission lacked jurisdiction to resolve a debt collection or settlement enforcement dispute between the insured and his agent.

The insured settled his statutory accident benefits claim with the insurer for $15,000.

The insurer provided the settlement cheque to the insured's agent, who misappropriated the funds.

The insured's estate brought an arbitration proceeding arguing that the insurer failed to comply with section 44(1)(a) of the Statutory Accident Benefits Schedule, which requires benefits to be mailed or delivered to the insured's residential address.

The arbitrator held that he had jurisdiction to hear the dispute and that section 44(1)(a) applies to settlement cheques.

The arbitrator found that the insurer breached this provision by delivering the cheque to the agent.

The hearing was adjourned to receive further evidence regarding a criminal restitution order against the agent before determining the insurer's final liability.

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

The insurer issued a settlement cheque, but the applicant maintained he did not receive his full entitlement and applied for arbitration.

A pre-hearing arbitrator divided the dispute into preliminary jurisdictional issues and main issues.

At the preliminary hearing, the arbitrator found that the witnesses and evidence for both sets of issues would be substantially similar.

Consequently, the arbitrator ordered that all issues be heard together at a new hearing date and directed each party to bear its own expenses for the preliminary hearing.