Linda M. Kiley

The respondent was injured when her horse was spooked by an oncoming ATV, causing her to be thrown and trampled in a muddy ditch.

She claimed statutory accident benefits from the appellant insurer.

The arbitrator found the incident was an 'accident' under the SABS.

The insurer appealed, arguing the horse and mud were intervening acts and the dominant feature of the injuries.

The Director's Delegate dismissed the appeal, finding the ATV was being put to an ordinary use and its operation was the direct cause and dominant feature of the incident, as spooking a horse is an ordinary risk of motoring on a rural road.

The appellant appealed an arbitrator's decision dismissing his application for arbitration regarding statutory accident benefits on the basis that it was filed beyond the two-year limitation period.

The appellant, who was self-represented and had been incarcerated, sought multiple extensions of time to file his appeal submissions.

The Director's Delegate refused to grant further extensions and rejected the appeal under Rule 51.2(b) of the Dispute Resolution Practice Code because it did not raise a question of law, but rather disputed the arbitrator's factual findings.

The respondent was awarded $1,250 in legal expenses for the appeal.

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

The insurer denied the claims.

The applicant applied for mediation and subsequently for arbitration.

The insurer raised a preliminary issue that the applications were filed beyond the limitation periods set out in the Insurance Act and the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant failed to comply with both the two-year limitation period to apply for mediation and the 90-day limitation period to apply for arbitration after the mediator's report.

The application for arbitration was dismissed.

The applicant withdrew his arbitration application for statutory accident benefits after commencing a court action.

The insurer brought a motion seeking to dismiss the arbitration, prohibit the applicant from commencing future FSCO arbitrations, and recover its $1,500 in expenses and $3,000 assessment fee, arguing the proceeding was frivolous, vexatious, and an abuse of process.

The arbitrator dismissed the insurer's motion, finding no evidence that the claim was trivial, commenced in bad faith, or pursued for an improper purpose.

The arbitrator also found the requested prohibition order overly broad and noted that the statutory provision allowing an award for the assessment fee had been repealed.

Each party was ordered to bear its own expenses.