Mark Phillips

Following an arbitration decision regarding statutory accident benefits, both the applicant and the insurer claimed their arbitration expenses under subsection 282(11) of the Insurance Act.

The arbitrator denied both claims.

The insurer was largely successful but failed to make any settlement offer, which undercut the conciliatory nature of the process.

The applicant had a comparatively small degree of success and made an inflated settlement offer that did not encourage an amicable resolution.

Consequently, neither party was awarded expenses.

Following an arbitration decision regarding statutory accident benefits, both parties sought their expenses of the hearing.

The insurer argued it was entirely successful on the issues at arbitration and should be awarded expenses based on the result.

The applicant argued the insurer prolonged the proceedings by failing to respond to a treatment plan until the final day of the hearing and by ignoring a written offer to settle.

The arbitrator found that success is only one criterion to be weighed, and that the insurer's failure to comply with the Schedule and respond to the settlement offer prolonged the proceeding.

The arbitrator ordered that each party bear its own expenses.

The applicant was struck by a motor vehicle and subsequently underwent arthroscopic knee surgery.

She sought payment for $2,261.56 in physiotherapy treatment under the Statutory Accident Benefits Schedule.

The insurer denied the claim, relying on an insurer's examination which concluded the knee surgery was unrelated to the accident and the therapy was unnecessary.

While the arbitrator found the knee injury was caused by the accident, the application was dismissed because the treating chiropractor's records did not demonstrate an understanding of the applicant's knee condition, rendering the treatment neither reasonable nor necessary.

Following a decision on statutory accident benefits where the insurer was found entitled to its reasonable expenses, the parties disagreed on the quantum of the insurer's Bill of Costs.

The insurer sought $6,867.08 in legal fees based on 110.7 hours of preparation and hearing time, plus disbursements.

The arbitrator found the hours excessive for a straightforward two-day hearing involving no complex legal issues.

Applying a 1.25:1 ratio for preparation to hearing time, the arbitrator reduced the legal fees and struck unsupported disbursements for courier, parking, and court reporting services.

The applicant was ordered to pay the insurer $4,861.18 in expenses.