OFSCDRS 2015

The applicant claimed statutory accident benefits following a motor vehicle accident and applied for arbitration when disputes arose with the insurer.

The applicant failed to communicate with his legal representatives for over a year and did not attend the arbitration hearing.

The applicant's counsel requested an adjournment, which was denied as there was no reasonable prospect of locating the applicant.

The arbitrator dismissed the application on a without costs basis due to abandonment.

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The Insurer requested that the Applicant attend an independent medical examination (IME) with a psychiatrist to assess his treatment plan, Minor Injury Guideline applicability, and entitlement to non-earner benefits.

The Applicant failed to attend, arguing that the IME should be conducted by a psychologist, not a psychiatrist.

The Arbitrator found that there was a reasonable nexus between the Insurer's choice of a psychiatrist and the Applicant's injuries, given the overlap in specialties and the Applicant's pre- and post-accident psychiatric issues.

The Applicant is precluded from moving to an Arbitration Hearing until he complies with the scheduled IME.

The applicant claimed statutory accident benefits following a motor vehicle accident and applied for arbitration at the Financial Services Commission of Ontario after mediation failed.

Prior to the hearing, the applicant's legal representatives were permitted to withdraw due to a breakdown in the solicitor-client relationship.

The applicant failed to attend the scheduled arbitration hearing despite being properly served with the Notice of Hearing.

The arbitrator proceeded in the applicant's absence pursuant to Rule 37.7 of the Dispute Resolution Practice Code and dismissed the claims, as the applicant presented no evidence to prove entitlement to the benefits.

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

Following an arbitration where the applicant was found subject to the Minor Injury Guideline and denied funding for disputed treatment plans, the insurer sought its expenses.

The arbitrator considered the parties' degree of success and written offers to settle.

Finding that the insurer was completely successful and that the applicant failed to accept the insurer's offer to settle on a timely basis, the arbitrator awarded the insurer its reasonable expenses of $10,701.50 inclusive of HST.

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

After the applicant's representatives were permitted to withdraw due to a breakdown in the solicitor-client relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

The arbitrator proceeded in the applicant's absence.

As the applicant presented no evidence to establish entitlement to the claimed benefits, the claims were dismissed.

The applicant was injured in a motor vehicle accident on October 29, 2010, and claimed statutory accident benefits.

The insurer reinstated her Income Replacement Benefits shortly before the arbitration hearing but disputed the need for an ongoing order and the applicable interest rate on overdue payments.

The arbitrator ordered ongoing IRBs at $400 per week.

On the issue of interest, the arbitrator held that because the accident occurred after September 1, 2010, the New Schedule applied, limiting the interest rate on overdue payments to 1 percent per month, despite the applicant holding a transitional policy.

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

At the arbitration hearing, the Applicants failed to attend.

Their representative requested and was permitted to withdraw due to a breakdown in the representative-client relationship.

As the Applicants presented no evidence to establish their entitlement to the benefits claimed, their claims were dismissed.

The Applicants were ordered to pay $1,500 each toward the Insurer's arbitration expenses.

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

After filing for arbitration, the applicant failed to attend three scheduled pre-hearings and the arbitration hearing itself.

The applicant's counsel of record was removed due to an irreparable breakdown in communication.

Given the applicant's failure to pursue the application, the arbitrator dismissed the application for arbitration in its entirety.

No costs were ordered.

The applicant sought statutory accident benefits, including non-earner, housekeeping, and medical benefits, following a 2009 motor vehicle accident.

The insurer denied the claims, arguing the accident was minor and the applicant's impairments stemmed from severe pre-existing workplace injuries.

The arbitrator dismissed the application, finding overwhelming evidence that the applicant's physical and psychological conditions pre-dated the accident.

The arbitrator concluded the applicant sustained only minor soft-tissue injuries in the 2009 accident and failed to prove entitlement to the claimed benefits.

The applicant's legal representatives brought a motion to be removed from the record due to a breakdown in communications, having lost contact with the applicant since March 2014.

The arbitrator granted the motion to withdraw.

The insurer also requested a production order for documents previously agreed to at a pre-hearing.

The arbitrator ordered the unrepresented applicant to produce the requested documents or provide proof of best efforts to obtain them by a specified date.

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

The insurer denied the benefits, and the applicant applied for arbitration.

A preliminary issue hearing was scheduled to determine if the applicant was involved in an 'accident'.

The applicant failed to attend the hearing.

The arbitrator proceeded in his absence under the Statutory Powers Procedure Act and the Dispute Resolution Practice Code.

As the applicant presented no evidence, he failed to meet his burden of proof, and his claim was dismissed.

The insurer was awarded $2,500 in expenses.

The insurer brought a motion for the production of police records in the possession of the Ministry of the Attorney General.

The Ministry consented to the production order subject to certain conditions and redactions.

The arbitrator found that the requirements of Rule 67.7 of the Dispute Resolution Practice Code were met, as the documents were reasonably required to ensure a just and fair hearing.

The motion was granted on consent.

The applicant brought a preliminary motion to remove the insurer's counsel due to an alleged conflict of interest, which was dismissed.

The insurer sought its expenses of $3,378.99 for the motion.

The arbitrator found that the insurer was not entirely successful, as its request to stay the motion was denied, warranting a 20% reduction.

The arbitrator further reduced the insurer's costs by 40% because the applicant's motion was not unnecessary given conflicting court decisions, the issue was of public interest, and the applicant was impecunious.

The insurer was awarded $1,297.38 in expenses, payable at the conclusion of the hearing on the merits.

The applicant was injured in a motor vehicle accident and the parties settled the issues in dispute.

A consent order was requested regarding expenses.

The arbitrator ordered, on consent, that the applicant pay $2,500 to the insurer and sign a full and final release for all claims.

The parties settled the issues in dispute in the arbitration regarding a motor vehicle accident and requested a consent order regarding expenses.

The arbitrator issued a consent order requiring the applicant to pay $2,500 to the insurer and sign a full and final release for all past, present, and future claims.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the non-catastrophic policy limits were exhausted.

The applicant brought a motion for interim attendant care and medical/rehabilitation benefits in excess of the non-catastrophic limits, pending a determination of whether he suffered a catastrophic impairment.

The arbitrator dismissed the motion, finding no jurisdiction to order payments over the statutory non-catastrophic limits prior to a finding of catastrophic impairment.

Furthermore, the arbitrator held that the applicant did not meet the threshold test for interim benefits, as the conflicting medical evidence resulted in an ambiguous case strength.

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

After her former counsel was removed from the record due to a breakdown in the solicitor-client relationship, the applicant failed to attend the pre-hearing and the rescheduled hearing despite being served with notice.

The arbitrator found that the applicant had abandoned her application and dismissed it for failure to establish entitlement to the claimed benefits.

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

The insurer scheduled multiple section 44 examinations, which the applicant refused to attend because the insurer did not provide a Cantonese interpreter accredited by the Ministry of the Attorney General.

The insurer offered other qualified interpreters, but the applicant maintained her refusal.

The arbitrator found that the absence of a MAG-certified interpreter was not a reasonable explanation for failing to attend the examinations, as there is no legislative requirement for such specific accreditation.

Consequently, the applicant was precluded from proceeding to mediation on the issues in dispute.

The applicant sought statutory accident benefits, including income replacement and housekeeping benefits, following a motor vehicle accident.

After her representative was removed from the record, the applicant failed to appear at the scheduled arbitration hearing.

The arbitrator proceeded in her absence and dismissed the application, finding that the applicant failed to meet her burden of proof.

The insurer was awarded $500 in expenses due to the applicant's failure to advance her claim.

The applicant was injured in a motor vehicle accident and claimed attendant care, housekeeping, and caregiver benefits from her insurer under a transitional policy.

The central legal issue was whether the new 'incurred' definition in the 2010 Statutory Accident Benefits Schedule, which requires non-professional service providers to demonstrate an economic loss, applied to her claims.

The arbitrator held that the applicant's rights vested on the date of the accident, meaning the 2010 Schedule's definition of 'incurred' applied.

Because the applicant's family members could not demonstrate a quantifiable economic loss, the claims for attendant care and caregiver benefits were denied.

However, the applicant was awarded partial housekeeping benefits for services provided by professional cleaners during the period she was substantially disabled from performing those tasks.