OFSCDRS 2013

The applicant applied for statutory accident benefits following a motor vehicle accident.

After her legal representative got off the record, the applicant failed to attend the pre-hearing conference and the arbitration hearing despite receiving written notice.

The arbitrator dismissed the application as abandoned and ordered the applicant to pay $750 in expenses to the insurer.

The applicant applied for statutory accident benefits following an alleged motor vehicle accident, which the insurer denied on the basis that the accident was staged.

The applicant's representative brought a motion to withdraw due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the arbitration hearing despite being properly served.

The arbitrator granted the representative's motion to withdraw and proceeded with the hearing in the applicant's absence.

As the applicant presented no evidence, the application for arbitration was dismissed, and the applicant was ordered to pay the insurer's expenses of $948.31.

The applicant applied for statutory accident benefits following an alleged motor vehicle accident, which the insurer denied on the basis that the accident was staged.

The applicant's representative brought a motion to withdraw due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the arbitration hearing.

The arbitrator granted the representative's motion to withdraw, dismissed the application for arbitration due to the applicant's failure to attend and present evidence, and ordered the applicant to pay the insurer's arbitration expenses.

The applicant applied for statutory accident benefits following an alleged motor vehicle accident.

The insurer denied the benefits on the basis that the accident was staged.

The applicant's representative brought a motion to withdraw due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the arbitration hearing despite being properly served with notice.

The arbitrator granted the representative's motion to withdraw and proceeded with the hearing in the applicant's absence.

As the applicant presented no evidence, the application for arbitration was dismissed, and the applicant was ordered to pay the insurer's arbitration expenses.

The insurer brought a motion to compel the insured to attend a neuropsychological examination under section 44 of the Statutory Accident Benefits Schedule and to stay the arbitration proceedings until he attended.

The insured had refused to attend, arguing his own treating psychologist should conduct the assessment.

The arbitrator found the examination was reasonably necessary to assess ongoing attendant care needs, noting the insured's last neuropsychological assessment was seven years prior.

The motion was granted, and the arbitration was stayed pending the insured's attendance at the examination.

The applicant was injured in a motor vehicle accident and claimed post-104 week income replacement benefits.

The insurer suspended benefits after the applicant failed to attend scheduled insurer examinations, and later formally refused benefits after the examinations were completed.

The insurer argued the arbitration application was time-barred under section 281.1 of the Insurance Act, relying on the initial suspension as the trigger for the limitation period.

The arbitrator held that the initial suspension was a temporary procedural stoppage, not a clear and unequivocal refusal, and lacked required information about the dispute resolution process.

Therefore, the limitation period was not triggered until the later formal refusal, making the applicant's mediation and arbitration applications timely.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment.

After the applicant served new catastrophic assessment reports shortly before the scheduled arbitration hearing, the insurer requested that the applicant attend updated insurer's examinations and sought an adjournment of the hearing.

The applicant refused to attend.

The arbitrator found that the new reports constituted new evidence supporting a new position, and that procedural fairness required allowing the insurer to conduct its own orthopaedic and psychiatric assessments.

The arbitration proceeding was stayed until the applicant attends the assessments, and the hearing was adjourned.

The applicant sought statutory accident benefits following an alleged motor vehicle accident.

The insurer took the position that the accident was staged and sought repayment of benefits already paid.

The applicant failed to attend the scheduled arbitration hearing.

Pursuant to Rule 37.7 of the Dispute Resolution Practice Code, the arbitrator proceeded in her absence and dismissed her claims for failing to establish entitlement.

The preliminary issue of whether the accident was staged was bifurcated and deferred to a future hearing to be coordinated with related applications.

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

The insurer alleged the accident was staged and sought repayment of benefits paid.

The substantive claims and preliminary issues were bifurcated.

The applicant failed to attend the hearing for the substantive claims.

Pursuant to Rule 37.7 of the Dispute Resolution Practice Code, the arbitrator proceeded in her absence and dismissed her claims for failing to establish entitlement.

The arbitrator declined to hear the insurer's preliminary issues regarding the staged accident at this hearing, as no notice had been provided to the applicant and related matters were pending.

The preliminary issues were deferred to be scheduled with the related matters.

The applicant sought statutory accident benefits following an alleged motor vehicle accident.

The insurer denied the claims, alleging the accident was staged, and sought repayment of benefits already paid.

The substantive claims and preliminary issues were bifurcated.

The applicant failed to attend the hearing for the substantive claims.

Pursuant to Rule 37.7 of the Dispute Resolution Practice Code, the arbitrator proceeded in the applicant's absence and dismissed the claims for failure to establish entitlement.

The arbitrator declined to determine the preliminary issues regarding the staged accident, directing that they be scheduled for a later hearing alongside related applications to avoid inconsistent results.

Following a finding that the applicant sustained a catastrophic impairment in a motor vehicle accident, the parties disputed the quantum of arbitration expenses.

The applicant claimed $99,184.04, including a premium for beating an offer to settle.

The arbitrator rejected the claim for a premium, finding no jurisdiction to award it.

Applying a 4:1 ratio for preparation to hearing time, the arbitrator assessed reasonable legal fees and disbursements, ultimately awarding the applicant $28,890.86 inclusive of HST.

The Applicant sought to vary or revoke an earlier appeal decision that upheld an arbitrator's finding that his application for arbitration was an abuse of process.

The Applicant also sought an interim award of benefits.

The Director's Delegate denied the interim award, finding the Applicant failed to establish a prima facie case or demonstrate necessity or urgency.

The Delegate rejected the application for variation/revocation, concluding that the Applicant failed to establish any of the statutory grounds under subsection 284(3) of the Insurance Act, namely new evidence, a material change in circumstances, or an error in the order.

The Delegate awarded $1,500 in legal expenses to the Respondent.

The applicant claimed statutory accident benefits following an alleged rear-end motor vehicle collision.

The insurer disputed the claim, raising the preliminary issue of whether an "accident" actually occurred as defined in the Statutory Accident Benefits Schedule.

The arbitrator found the applicant's testimony lacked credibility due to numerous inconsistencies regarding the time, location, weather, and vehicle condition.

Furthermore, two accident reconstruction specialists concluded that the physical damage to the vehicles was inconsistent with the reported collision.

The arbitrator concluded the applicant failed to prove on a balance of probabilities that he was involved in an accident, and dismissed the claims for accident benefits.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them using an OCF-17 form.

The insurer argued the applicant was barred from proceeding to arbitration because the two-year limitation period had expired.

The arbitrator found that the OCF-17 form used by the insurer was confusing and did not comply with the Statutory Accident Benefits Schedule or the Supreme Court's decision in Smith v. Co-operators.

Specifically, the form misleadingly suggested that a Designated Assessment Centre (DAC) assessment was mandatory to dispute the stoppage of benefits.

As the notice was invalid, the limitation period did not begin to run, and the applicant was permitted to proceed to arbitration.

The insurer brought a motion to dismiss the applicant's application for arbitration regarding statutory accident benefits.

The applicant failed to attend the motion hearing, failed to produce relevant documents, and instructed her former counsel to take no further steps on her behalf.

The arbitrator found that the applicant had abandoned her claim without reasonable excuse and dismissed the application, awarding $750 in costs to the insurer.

The applicant applied for statutory accident benefits following a motor vehicle accident and subsequently initiated arbitration at the Financial Services Commission of Ontario.

The applicant's representative brought a motion to withdraw from the record due to a complete breakdown in communication and loss of contact with the applicant.

The insurer brought a motion to dismiss the arbitration and sought its expenses.

The arbitrator granted the representative's motion to withdraw, finding that the proper procedures were followed.

The arbitrator also dismissed the arbitration without a hearing under the Statutory Powers Procedure Act, finding that the applicant's repeated failure to attend hearings or participate in the process was vexatious.

The applicant was ordered to pay the insurer's expenses fixed at $2,272.53.

The insurer brought a motion to adjourn the arbitration hearing to consolidate it with two other claims arising from the same alleged motor vehicle accident, which the insurer now claimed was staged.

The applicant opposed the adjournment, arguing prejudice due to the insurer's delay in raising the misrepresentation issue.

The arbitrator granted the adjournment sine die to allow for consolidation, noting the risk of diverging findings if the matters were heard separately.

To address the prejudice to the applicant caused by the late adjournment request, the arbitrator ordered the insurer to pay $5,000 in expenses thrown away, prohibited the filing of further evidence without leave, and made the new hearing dates peremptory to the insurer.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The matter proceeded to an arbitration hearing, but the applicant failed to attend, communicate with the Commission, or provide instructions to his counsel.

As no evidence was presented to prove the applicant's claims, the arbitrator dismissed the arbitration.

The insurer was awarded its reasonable expenses and disbursements, assessed at $3,384.26, after a reduction for efficiencies gained from a related consolidated matter.

The applicant applied for statutory accident benefits following a motor vehicle accident.

The applicant failed to attend the scheduled arbitration hearing and his legal representatives were removed from the record after losing contact with him.

The arbitrator dismissed the application due to abandonment and lack of evidence.

The insurer was awarded $3,000 in expenses.

The insurer brought a motion for an order compelling the insured to attend insurer medical examinations with a psychologist and a physiatrist under section 44 of the Statutory Accident Benefits Schedule.

The insured argued the examinations were primarily for hearing preparation.

The arbitrator found the examinations were reasonable and necessary because the insured's delayed and limited productions restricted the insurer's ability to assess the claim.

The arbitration was stayed pending the insured's attendance at the examinations.