Michael Gillen

The applicant, a 70-year-old retiree, was injured in a motor vehicle accident and suffered a compression fracture of the L4 vertebrae.

The insurer paid weekly benefits under section 13 of the Statutory Accident Benefits Schedule but terminated them on April 21, 1993, arguing the applicant was no longer substantially unable to perform his essential pre-accident tasks.

The arbitrator determined the applicant's essential tasks included personal care, limited household chores, and a daily walk.

The arbitrator found that the applicant remained substantially unable to perform these tasks until June 8, 1993, when he was discharged from a physiotherapy program having resumed about 70% of his normal daily regimes.

The applicant was awarded weekly benefits for the closed period from April 21 to June 8, 1993, plus interest and arbitration expenses.

The applicant, a taxi driver, was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them based on a functional capacity evaluation.

The applicant sought ongoing benefits and disputed the calculation of his pre-accident income.

The arbitrator found that the applicant remained substantially disabled from his occupation, as the functional evaluation failed to account for the 12-hour shifts required for his work to be reasonably remunerative.

Regarding the calculation of benefits, the arbitrator held that the applicant's farm losses were investment losses and should not reduce his pre-accident income.

However, the arbitrator ruled that the applicant's pre-accident income should be averaged over 52 weeks, rather than the 47 weeks he actually worked, to account for his vacation period.

The applicants, two brothers, were injured in a motor vehicle accident and sought weekly income benefits from their insurer.

The insurer terminated benefits in the summer of 1992.

Following an arbitration hearing, the arbitrator determined the applicants' pre-accident weekly incomes and calculated their respective benefit amounts.

Based on medical and psychological evidence, the arbitrator found that one applicant was disabled from his job as a bodyshop helper until December 30, 1992, and the other was disabled from his job as a cleaner until April 30, 1993.

Claims for repayment by the insurer and a special award by the applicants were dismissed due to a lack of evidence.

The applicants were awarded their arbitration expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them based on surveillance video showing him moving furniture.

The applicant applied for arbitration.

The arbitrator found that the applicant, a heavy equipment operator, remained substantially unable to perform his essential tasks and reinstated the $600 weekly benefits.

The arbitrator also found the insurer acted unreasonably in terminating benefits without further medical investigation or discussing the video with the applicant, awarding a $2,000 special award to the applicant.

The applicant was injured in a motor vehicle accident while laid off and receiving unemployment insurance benefits.

He applied for weekly income benefits under the No-Fault Benefits Schedule.

The insurer denied the claim, arguing he was capable of working.

The arbitrator found the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment for a limited period.

The arbitrator determined that the applicant's gross weekly income should be averaged over the full 52 weeks preceding the accident, including periods of unemployment, resulting in a weekly benefit of $455.58.

The arbitrator also held that short-term disability benefits from another plan were not 'available' to the applicant and should not be deducted.