Ralph D’Angelo

The appellant appealed an arbitrator's decision dismissing his claims for statutory accident benefits against the insurer.

The arbitrator had found that the appellant failed to commence mediation within the two-year limitation period.

On appeal, the Director's Delegate found that the appellant's failure to notify the insurer of the accident until six months after it occurred, without a reasonable explanation, was determinative and precluded him from proceeding to arbitration for any claims arising out of the accident.

The appeal was dismissed.

The insurer appealed an arbitration order requiring it to pay income replacement benefits (IRBs) pending the resolution of a dispute over loss of earning capacity benefits (LECBs).

The Director's Delegate held that under the Statutory Accident Benefits Schedule, an insurer's obligation to pay IRBs does not automatically cease when it makes an offer of zero LECBs.

The appeal was dismissed, but the order was modified to require payment of IRBs only up to the date of the appeal decision, as the underlying dispute had been moved to the courts.

The appellant, the sole voting shareholder of a family business, appealed an arbitrator's decision finding him to be self-employed rather than an employee for the purpose of calculating his weekly income replacement benefits.

The appellant argued that a salary scheme implemented shortly before his motor vehicle accident established an employer-employee relationship, which would have entitled him to higher benefits based on a four-week period.

The Director's Delegate upheld the arbitrator's finding that the salary arrangement was a tax management strategy rather than a true employment contract, noting the lack of a consistent pattern of salary payments and the company's financial history.

The appeal was dismissed, and the arbitrator's disallowance of expenses for the appellant's accountant was also upheld.

The insurer appealed an arbitration order finding that the insured's application for arbitration was not statute-barred.

The insurer argued that it had mailed a notice of refusal to pay benefits, triggering the two-year limitation period under the Insurance Act.

The Director of Arbitrations dismissed the appeal, finding insufficient evidence that the notice of refusal ever left the insurer's internal mail system or was received by the insured.

As a result, the limitation period had not commenced, and the insured's application was allowed to proceed.

The appellant, a taxi driver, appealed an arbitration decision denying him additional weekly income benefits following a motor vehicle accident.

The arbitrator had found that the appellant's back pain was due to a pre-existing condition and that his evidence regarding his inability to work and his pre-accident income was not credible.

On appeal, the Director's Delegate upheld the arbitrator's findings, noting there was ample evidence to support the conclusions on credibility and the weight given to the medical evidence.

The appeal was dismissed, and claims for a special award and expenses were denied.

The appellant was involved in two motor vehicle accidents and claimed weekly income benefits and supplementary medical benefits.

The arbitrator terminated weekly income benefits as of October 1, 1992, and denied the medical benefits.

Both the appellant and one of the insurers appealed the decision.

The Director's Delegate dismissed the appeals, finding that the arbitrator's conclusions were supported by the evidence, including the finding that the appellant's fibromyalgia was not significantly contributed to by the accidents.