Martin E. Tiidus

The applicant was injured in a motor vehicle accident one week after starting a new job as a superintendent.

She applied for income replacement benefits.

The insurer calculated her benefits based only on the $308 she earned in the four weeks preceding the accident, resulting in a weekly benefit of $59.69.

The applicant argued her benefits should be extrapolated to reflect her annual salary of $16,000.

The arbitrator held that under the Statutory Accident Benefits Schedule, the income must be based on the amount actually earned in the four weeks prior to the accident, confirming the $59.69 weekly benefit.

The issues of repayment of caregiver benefits and expenses were adjourned for an evidentiary hearing.

The appellant insurer appealed an arbitration decision finding that the respondent claimant had a reasonable excuse for failing to notify the insurer of his accident benefits claim within 30 days of the accident.

The claimant's application was submitted nearly 18 months late due to a combination of personal problems and his first lawyer's failure to advance the claim.

The Director's Delegate upheld the arbitrator's finding that the claimant's personal circumstances constituted a reasonable excuse and that the insurer was not prejudiced by the delay, as the claimant's history of non-compliance meant earlier intervention would not have altered his recovery.

The appeal was dismissed.

The applicant was injured in a motorcycle accident and claimed statutory accident benefits, including care benefits for his wife who took time off work to care for him, and weekly income benefits.

The arbitrator found that the applicant required full-time care only during his two-month recuperation from spinal surgery, awarding care benefits for that period but denying them thereafter, as his ongoing vertigo and orthopaedic injuries did not necessitate 24-hour supervision.

On the issue of income benefits, the arbitrator held that the applicant's prior workers' compensation and no-fault benefits did not constitute 'income from employment', meaning his weekly benefits had to be calculated based on the statutory deemed minimum earnings.

The arbitrator remained seized of the insurer's claim for repayment of an alleged overpayment pending a pending Divisional Court ruling.