Nathalie Rosenthall

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits from Unifund Assurance Company based on a fraudulent pink insurance slip provided by the owner of the vehicle he was driving.

Unifund refused to respond, arguing there was no nexus between it and the applicant.

The arbitrator held that the applicant's choice of insurer was not arbitrary or random, as he relied on the police report which listed Unifund based on the fraudulent slip.

Therefore, a sufficient nexus existed, and Unifund was the first insurer required to pay benefits pending any priority dispute.

The applicant sought a preliminary order to exclude several insurer's medical reports and prohibit their authors from testifying at an upcoming arbitration hearing.

The applicant argued that the insurer was not entitled to request further assessments under section 42 of the Schedule after having previously terminated income replacement benefits based on a WAD II diagnosis.

The arbitrator dismissed the motion, finding that an insurer has an ongoing right and obligation to assess a claim as it progresses, particularly when new medical information suggests the injuries may be more severe than initially diagnosed.

The exclusion of evidence was deemed an extraordinary remedy not justified in these circumstances.

The Applicant, injured in a motor vehicle accident, sought statutory accident benefits and applied for arbitration.

At a pre-hearing, the Applicant requested an order for the production of particulars related to surveillance conducted by the Insurer, regardless of whether the Insurer intended to rely on it at the hearing.

The Arbitrator, bound by a previous appeal decision, held that the Insurer is not obligated to disclose surveillance evidence unless and until it decides to rely upon it at the arbitration hearing.

The request for production was denied.