Lisa Ann Armstrong

The applicant sought statutory accident benefits following a motor vehicle accident.

After failing to attend a pre-hearing discussion and failing to respond to multiple communications, the insurer brought a motion to dismiss the application.

The applicant and his representative failed to participate in the motion.

The arbitrator dismissed the application for arbitration without a hearing, finding it frivolous, vexatious, and/or commenced in bad faith.

The insurer was awarded $1,000 in expenses.

The appellant challenged summary judgment dismissing her statutory accident benefits action for non-earner benefits as out of time.

The court held that a clear and unequivocal denial of benefits triggered the two-year limitation period, even though the insurer gave an incorrect legal reason for ineligibility.

The limitation period ran from the initial refusal of non-earner benefits, not from the later termination of income replacement benefits.

The court further held that neither the Insurance Act nor the SABS required the insurer to give renewed notice of a possible entitlement to a previously denied benefit upon termination of another benefit.

The appeal was dismissed with costs.

The appellant suffered severe physical and psychological injuries, including a leg amputation and clinical depression, in a motor vehicle accident.

He sought enhanced statutory accident benefits, arguing he was catastrophically impaired.

The trial judge held that physical and psychological impairments could not be combined under section 2(1.1)(f) of the Statutory Accident Benefits Schedule to meet the 55 per cent whole person impairment threshold.

The Court of Appeal reversed this decision, finding that the language of the Schedule, the purpose of the American Medical Association's Guides, and the goals of the statutory scheme permit the combination of physical and psychiatric impairments to determine catastrophic impairment.

The parties settled a dispute regarding statutory accident benefits, but a disagreement arose over the execution of the release.

The insurer required the insured's counsel to sign a certificate confirming the release was explained, which the insured refused on the basis of solicitor-client privilege.

The arbitrator found a binding settlement existed, held the insurer's requirement was arbitrary, and ordered payment of the settlement funds plus a special award for unreasonable withholding.

On appeal, the Director's Delegate upheld the finding of a binding settlement and the award of interest, noting that a witnessed release is standard practice.

However, the Delegate rescinded the special award, finding that the insurer's attempt to negotiate the release terms did not constitute unreasonable behaviour warranting a special award.

The appeal was allowed in part.

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

The parties reached a settlement at a settlement conference.

The insurer forwarded a release that included a certificate to be signed by the applicant's lawyer, confirming the lawyer had explained the release to the applicant.

The applicant's lawyer refused to sign the certificate, citing solicitor-client privilege, and refused to witness the applicant's signature.

The insurer refused to pay the settlement funds without the witnessed release or lawyer's certificate.

The arbitrator held that the Settlement Regulation governs the requirements for a valid settlement and does not mandate a lawyer's certificate or witnessing of the signature.

The arbitrator ordered the insurer to pay the settlement funds and awarded a special award of $1,625, finding the insurer's withholding of funds based on an arbitrary, non-statutory requirement to be unreasonable to a flagrant degree.

The applicant applied for arbitration regarding statutory accident benefits following a motor vehicle accident.

A preliminary issue hearing was directed to determine whether the applicant possessed the mental capacity to proceed in the dispute resolution process, given his acquired brain injury and difficulties organizing his thoughts.

The arbitrator found that the applicant was presumed to have capacity and that there was insufficient evidence to rebut this presumption.

The applicant demonstrated an understanding of the process, the relief sought, and the possible outcomes.