Mark Hugo Fonseca

The appellant appealed a summary judgment dismissing his action against his own motor vehicle liability insurer for uninsured or unidentified automobile coverage.

The appellant was struck from behind in a motor vehicle accident and argued that if the jury found neither of the two identified drivers liable at trial, he should be able to recover under the uninsured/unidentified automobile coverage.

The Court of Appeal upheld the dismissal, finding that there was no unidentified automobile involved in the accident and that the sole question at trial would be which, if either, of the two known vehicles or drivers was legally responsible.

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

The applicant failed to attend the arbitration hearing on two separate occasions.

The arbitrator granted the insurer's motion to dismiss the application for arbitration.

The arbitrator also awarded the insurer its expenses of the proceeding, assessing costs at $4,836.92 based on the applicant's failure to participate, which unnecessarily prolonged the process.

The applicant sought medical benefits following an alleged motor vehicle accident.

The insurer denied the claims, alleging the accident was staged and the applicant was not a passenger.

The applicant and her former representative failed to attend the arbitration hearing.

Based on inconsistencies in statements and evidence from another alleged passenger that the accident was fabricated, the arbitrator found the applicant was not involved in an accident and dismissed the arbitration.

The arbitrator awarded the insurer its arbitration expenses of $1,943.52, holding the applicant and her former representative jointly and severally liable due to their non-participation and the vexatious nature of the proceeding.

The applicant sought statutory accident benefits after being struck by a bicycle while walking away from his friend's parked van, having just retrieved a package from it.

The insurer denied the claim on the basis that the incident did not meet the definition of an 'accident' under the Statutory Accident Benefits Schedule.

The arbitrator held that while retrieving a package is an ordinary activity attached to automobile use, the direct cause of the injuries was the bicycle, which constituted a new and independent intervening force.

The applicant's proximity to the vehicle was merely coincidental.

The claim for accident benefits was dismissed.

The Estate of Mark Green applied for arbitration claiming income replacement benefits following a motor vehicle accident.

Shortly before the hearing, the Estate requested to withdraw its application, citing economic non-viability.

The insurer opposed withdrawal without conditions, arguing the application was frivolous and an abuse of process because the Estate never provided basic documentation to support the claim and the deceased was not employed at the time of the accident.

The Arbitrator allowed the withdrawal but ordered the Estate to pay the insurer's $3,000 assessment fee and reasonable legal expenses, finding the application was devoid of merit when commenced and constituted an abuse of process.

The applicant sought statutory accident benefits for acupuncture treatment following a motor vehicle accident.

The applicant failed to attend the arbitration hearing, and her representative successfully moved to withdraw from the record due to a loss of contact.

In the absence of any supporting evidence, the arbitrator dismissed the applicant's claims.

The insurer's request for the return of its assessment fee under s. 282(11.2) of the Insurance Act was denied, as the application was not shown to be frivolous or an abuse of process when commenced, but the insurer was awarded $1,500 in hearing expenses.

The applicant was injured in a motor vehicle accident when struck as a pedestrian.

He applied for statutory accident benefits, including housekeeping expenses.

The insurer paid housekeeping expenses until March 19, 1999, but terminated them after the applicant refused an assessment.

At arbitration, the arbitrator found that the applicant did not suffer a substantial inability to perform the housekeeping and home maintenance services he normally performed before the accident.

The application for housekeeping expenses was dismissed.

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

The insurer subsequently terminated benefits and sought repayment, arguing the applicant knew or ought to have known he was driving an uninsured vehicle.

The arbitrator found that the applicant's wife had cancelled the insurance policy prior to the accident and that the applicant was aware of this cancellation.

Consequently, the applicant was disqualified from receiving benefits under section 30(1)(a) of the Statutory Accident Benefits Schedule.

The applicant was ordered to repay $6,357.02 in income replacement benefits pursuant to section 47(1)(b), but was not required to repay other benefits as the insurer failed to prove fraud or misrepresentation under section 47(1)(a).

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits and supplementary medical benefits for prescriptions after the insurer terminated them.

The arbitrator found that the applicant was not physically disabled from returning to her pre-accident employment as a hairstyling instructor.

However, the arbitrator concluded that the applicant suffered from accident-related panic attacks that substantially disabled her from working during an acute phase between December 1996 and August 1997.

Income replacement benefits were awarded for this limited period.

The arbitrator also awarded the cost of most claimed prescriptions, finding them reasonable and necessary for treating her accident-related psychological condition.

The appellants, husband and wife, were injured in a motor vehicle accident and received weekly income benefits.

The insurer later terminated the husband's benefits and sought repayment of an alleged overpayment, arguing he had underreported post-accident self-employment income and overstated pre-accident income.

The arbitrator ordered the husband to repay over $92,000.

On appeal, the Director's Delegate found the arbitrator erred in calculating the start date of a pre-accident contract and the method of deducting post-accident corporate income from periodic benefits.

The appeal was allowed in part, reducing the husband's repayment to $32,475.23 and ordering the insurer to pay the wife an additional $8,953.54.

The arbitrator's finding that the husband's lack of candour contributed to the overpayment, justifying the repayment order, was upheld.

The applicants were injured in a motor vehicle accident and sought statutory accident benefits.

The insurer terminated the husband's weekly income benefits, prompting an arbitration.

The arbitrator found that the husband was entitled to benefits for a limited period but had failed to disclose post-accident self-employment income, resulting in a substantial overpayment.

Surveillance evidence demonstrated the husband was capable of performing his pre-accident work.

The husband was ordered to repay over $92,000 to the insurer.

The wife was found to have been underpaid and was awarded the balance owed.

The appellant appealed two arbitration decisions denying his claims for weekly benefits and supplementary medical and rehabilitation benefits following a motor vehicle accident.

The appellant argued that the arbitrator was biased, misapprehended the medical evidence, and improperly relied on surveillance evidence.

The Director's Delegate dismissed the appeals, finding no evidence of bias and concluding that the arbitrator's factual findings were supported by the evidence.

The arbitrator properly applied the 'essential tasks' test for weekly benefits and reasonably concluded that the appellant's requested psychological and computer training rehabilitation was not necessitated by the accident.

The applicant sought payment for medical and rehabilitation benefits, including psychological assessments, therapy, computer training, and chiropractic treatments, following a 1991 motor vehicle accident.

The arbitrator found significant discrepancies between the applicant's initial medical reports and his later complaints, concluding that the applicant had reconstructed his medical history.

The arbitrator gave little weight to the reports of the applicant's recently retained psychologist and chiropractor because they did not address these discrepancies and did not testify.

The claims for benefits, a special award, and arbitration expenses were dismissed.

The insurer's request for an assessment against the applicant for a frivolous arbitration was also dismissed.