OFSCDRS 2006

The applicant claimed statutory accident benefits following a motor vehicle accident.

The insurer denied benefits, alleging material misrepresentation based on discrepancies between the applicant's statement and a truck driver's statement.

The insurer sought production of the Crown brief from related criminal charges against the applicant.

The arbitrator held that the insurer must follow the screening mechanism established in D.P. v. Wagg to compel production of the Crown brief, which requires notice to the Attorney General and the relevant police service.

The arbitrator ordered the applicant to first disclose the nature of the charges and list any Crown brief materials in her possession.

The applicant's claim for death benefits following the death of her daughter in a motor vehicle accident was previously dismissed because she failed to establish financial dependence.

In this subsequent decision on expenses, both parties sought their costs of the arbitration.

Applying the criteria under Rule 75.2 of the Dispute Resolution Practice Code, the arbitrator awarded reasonable expenses to the insurer.

The arbitrator noted that while the applicant proceeded efficiently and honestly believed in the merits of her sensitive case, the insurer was entirely successful on the principal issue and no novel issues were raised.

The applicant sought arbitration for outstanding medical assessment accounts following a motor vehicle accident.

After her initial counsel's practice was taken over by the Law Society, her new counsel advised the insurer and the assessment facilities that the applicant would not be pursuing the outstanding accounts.

The applicant failed to attend the pre-hearing conference and the arbitration hearing.

The arbitrator dismissed the application, finding the applicant failed to discharge her onus of establishing entitlement to the claimed benefits.

No costs were awarded.

The applicant sought statutory accident benefits for medical treatment following a motor vehicle accident.

The insurer denied the claims, arguing the treatment plan was submitted late and the treatment was not reasonable and necessary.

The arbitrator found that the applicant was precluded from arbitrating the treatment plan because it was submitted beyond the 30-day limit.

In the alternative, the arbitrator relied on insurer examinations and a DAC assessment to conclude the treatment was not reasonable and necessary.

The application was dismissed.