Michael D. Smitiuch

The appellant appealed an arbitrator's order dismissing her claims for statutory accident benefits on the basis that the parties had reached a binding settlement.

The appellant argued that she lacked capacity, was under duress, and had rescinded the agreement.

The Director's Delegate found no error in the arbitrator's conclusion that the settlement complied with the regulatory requirements, that there was no compelling evidence of incapacity or duress, and that the appellant failed to rescind the agreement within the required two-day period.

The appeal was dismissed.

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

The insurer terminated her income replacement benefits on February 4, 1998.

The applicant applied for mediation on June 16, 1999, but the application was returned by FSCO due to deficiencies.

The applicant did not correct the deficiencies until August 15, 2000, well after the two-year limitation period had expired on February 4, 2000.

The arbitrator found that the applicant failed to commence a valid mediation within the prescribed time limit and could not retroactively cure the defect to revive the original application.

The arbitration was dismissed as time-barred.

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

The insurer made an offer of Loss of Earning Capacity Benefits (LECBs).

The applicant disputed the residual earning capacity (REC) component but did not expressly dispute the pre-accident earning capacity (PEC) component within 45 days.

The insurer brought a preliminary motion arguing the applicant was time-barred from arbitrating the PEC issue under s. 281(5) of the Insurance Act and s. 72(1) of the Schedule.

The arbitrator dismissed the motion, finding that under the Schedule, silence is deemed a rejection of both the REC and PEC components of the offer, and the limitation period had not expired.

The applicant was injured in a motor vehicle accident while driving an uninsured vehicle.

He applied for statutory accident benefits, including income replacement benefits, from the third-party insurer.

The insurer denied the claim under paragraph 30(1)(a) of the 1996 Statutory Accident Benefits Schedule, arguing the applicant knew or ought reasonably to have known the vehicle was uninsured.

The arbitrator found that the applicant could not reasonably have expected that either his bankrupt mother or her trustee in bankruptcy were paying for the insurance.

The arbitrator concluded that an ordinary, rational person in the applicant's situation ought reasonably to have known the vehicle was uninsured.

The claim for income replacement benefits and a special award was dismissed.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated weekly income benefits.

The applicant applied for arbitration, seeking ongoing weekly income benefits, transportation expenses, and a special award.

The arbitrator found that the applicant suffered from chronic pain and depression caused by the accident, which continuously prevented him from engaging in any suitable employment.

The arbitrator ordered the insurer to pay ongoing weekly income benefits and transportation expenses.

However, the arbitrator also ordered the applicant to repay an overpayment of income replacement benefits due to his receipt of collateral benefits, and denied the request for a special award.