OFSCDRS 2015

The applicant's representative brought a motion to be removed from the record due to a material breakdown in the solicitor-client relationship, as the applicant failed to communicate or attend proceedings.

The insurer brought a motion to dismiss the application for arbitration.

The arbitrator granted the representative's motion to be removed and dismissed the application for arbitration without costs, noting the applicant had ample notice and failed to participate.

The applicants sought accident benefits following a motor vehicle accident.

After their representative was removed from the record due to a breakdown in the solicitor-client relationship, the applicants failed to attend scheduled pre-hearing discussions and the motion hearing.

The insurer brought a motion to dismiss the applications for arbitration.

The arbitrator granted the motion, dismissing the applications without costs due to the applicants' failure to participate.

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

After mediation failed, she applied for arbitration.

At a pre-hearing, her counsel was removed from the record due to a breakdown in the solicitor-client relationship.

The applicant subsequently failed to attend the scheduled arbitration hearing by teleconference.

The insurer brought a motion to dismiss the application.

The arbitrator granted the motion, finding the applicant failed to meet her onus of proof by not attending, and dismissed the application for arbitration, awarding $1,000 in expenses to the insurer.

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

At a pre-hearing, the applicant participated briefly by telephone from Sri Lanka, but his identity could not be confirmed and he failed to attend the resumed in-person pre-hearing.

The applicant's legal representative brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, which was granted.

Due to the applicant's failure to attend the resumed pre-hearing, the arbitrator dismissed the application for arbitration as frivolous, vexatious, and/or commenced in bad faith pursuant to Rule 68.1 of the Dispute Resolution Practice Code.

The applicant sought accident benefits following a motor vehicle accident.

After her legal representatives were removed from the record due to an inability to contact her, the applicant failed to attend a mandatory pre-hearing conference.

The insurer moved to dismiss the application.

The arbitrator found that the applicant had been notified of the proceedings and warned of the consequences of non-attendance.

Given her failure to participate and meet her onus of proof, the application for arbitration was dismissed pursuant to Rule 68 of the Dispute Resolution Practice Code and section 23 of the Statutory Powers Procedure Act.

The applicant's representative brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, as the applicant failed to communicate or attend scheduled pre-hearings.

The insurer brought a motion to dismiss the application for arbitration.

The arbitrator granted the representative's motion to be removed and dismissed the application for arbitration with costs of $950 payable by the applicant, noting the applicant's failure to attend or communicate despite ample notice.

The applicant failed to attend multiple scheduled pre-hearings, including a final mandatory in-person pre-hearing.

The arbitrator dismissed the application for arbitration without a hearing under Rule 68 of the Dispute Resolution Practice Code, finding the application to be frivolous, vexatious, or commenced in bad faith due to the applicant's failure to participate.

The insurer's request for costs was denied.

The insurer brought a motion to dismiss the insured's Application for Arbitration on the basis that the insured failed to attend requested Insurer's Examinations under section 44 of the Statutory Accident Benefits Schedule.

The insured had refused to attend the examinations, arguing they were a waste of money and a paper review would suffice.

The arbitrator found that the insured failed to provide a reasonable excuse for non-attendance and that the insurer was prejudiced by the delay.

The motion was granted and the Application for Arbitration was dismissed.

The Insurer sought its expenses following an arbitration proceeding where all of the Applicant's claims for statutory accident benefits were dismissed.

The Applicant did not participate in the expense hearing.

The Arbitrator found that the Insurer was completely successful and therefore entitled to its reasonable expenses.

After adjusting the hourly rate claimed by the Insurer's counsel to the appropriate Legal Aid rate, the Arbitrator fixed the Insurer's expenses at $12,500.00, inclusive of fees, disbursements, and taxes, and ordered the Applicant to pay this amount.

The applicant, who suffered from chronic pain following a motor vehicle accident, sought $62,877.65 from his insurer for the cost of constructing a residential therapy pool.

The insurer had previously approved and funded aqua therapy at a community pool.

The arbitrator found that while aqua therapy was beneficial for the applicant's re-conditioning, a custom residential pool was not a reasonable and necessary medical expense.

The evidence indicated that the applicant's treatment goals could be met through community pool sessions and other forms of exercise, and the high cost and convenience factors did not justify the expense.

The application for the medical benefit was dismissed.

The applicants, injured in a 2008 motor vehicle accident, sought an interim order for funding of catastrophic impairment rebuttal reports in the amount of $26,352.00 each.

The insurer had partially approved the treatment plans for $8,000.00 per applicant based on a prior pre-hearing agreement.

The arbitrator found that the claim for funding fell under the 1996 Schedule, which restricts the insurer's funding obligation to portions of the report relevant to the denial.

Applying the Bernicky criteria, the arbitrator concluded the requested interim expenses were not shown to be reasonable and necessary for the conduct of the arbitration at this stage, leaving the issue of the additional assessments and their admissibility to the hearing arbitrator.

The motion was dismissed.

Following the dismissal of the appellant's appeal, both parties sought their legal expenses.

The Director's Delegate found that the respondent was entirely successful on the appeal, which was unnecessarily complicated by the appellant.

The appellant was ordered to pay the respondent's legal expenses fixed at $5,000 inclusive of HST.

The applicants claimed accident benefits following a motor vehicle collision.

The insurer denied the claims on the basis that the collision arose from the applicants' intentional and wilful acts.

The applicants failed to attend a scheduled pre-hearing and did not file any submissions in response to the insurer's motion to dismiss.

The arbitrator found that the applicants failed to meet their onus of proof and abandoned their claims.

The applications for arbitration were dismissed, and each applicant was ordered to pay $4,181.34 in expenses to the insurer.

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

After his counsel was removed from the record, the applicant failed to attend two pre-hearings and a preliminary issue hearing, despite receiving proper notice.

The arbitrator concluded that the applicant had abandoned his claim and dismissed the application for arbitration.

No order was made with respect to costs.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, including non-earner benefits.

The insurer denied the non-earner benefits on October 28, 2011, after receiving insurer's examination reports.

The applicant applied for mediation for non-earner benefits on August 12, 2014, more than two years after the denial.

The arbitrator held that the applicant was precluded from proceeding to arbitration for non-earner benefits because she failed to commence a mediation proceeding within the two-year limitation period set out in the Insurance Act and the Statutory Accident Benefits Schedule.

The arbitrator rejected the applicant's arguments that the limitation period did not begin to run until she submitted a disability certificate or that the denial was premature and therefore void.

The applicant sought accident benefits following a motor vehicle accident but failed to attend multiple scheduled pre-hearings or communicate with his counsel, leading to his counsel's removal from the record.

The insurer brought a motion to dismiss the arbitration for failure to participate.

The arbitrator found that the applicant's conduct demonstrated no genuine interest in pursuing the arbitration, rendering the proceeding frivolous and vexatious.

The application for arbitration was dismissed, and the applicant was ordered to pay $750 in costs to the insurer.

The applicant failed to attend multiple pre-hearings and lost contact with his representative.

The representative brought a motion to be removed from the record, and the insurer brought a motion to dismiss the arbitration and for costs.

The arbitrator granted the representative's request to be removed, dismissed the arbitration due to the applicant's failure to proceed, and awarded $678.00 in costs to the insurer.

The appellant insurer sought to appeal an arbitrator's preliminary decision which found that the respondent insured had sustained a catastrophic impairment following a motor vehicle accident.

The arbitrator based this finding on the respondent's Glasgow Coma Scale scores of 9 and a diagnosis of concussion, applying the binding legal test that the severity of the brain injury is irrelevant if the statutory GCS criteria are met.

The Director's Delegate rejected the interlocutory appeal, finding no strong grounds to depart from established case law and concluding that the most efficient resolution was to defer any appeal until all issues in the arbitration were finally decided.

The Delegate also refused to stay the arbitrator's order, noting the hardship a stay would cause the respondent whose minor injury benefits had been exhausted.

The Applicant sought her expenses and a Special Award following a successful arbitration for statutory accident benefits against the Insurer.

The Arbitrator found that the Insurer unreasonably withheld and delayed payments for Non-Earner and Medical Benefits despite compelling medical evidence from the Applicant's experts.

The Insurer's conduct, including an inadequate all-inclusive settlement offer, warranted a Special Award.

The Arbitrator ordered the Insurer to pay the Applicant's expenses fixed at $28,415.06 plus HST, and a Special Award of $13,000.00 inclusive of interest.

The applicant sought accident benefits following a motor vehicle accident.

Her legal counsel brought a motion to be removed from the record due to a complete breakdown in the solicitor-client relationship and an inability to contact the applicant for several months.

The applicant failed to participate in a scheduled pre-hearing discussion and the subsequent motion hearing.

The arbitrator granted counsel's request to be removed from the record and dismissed the application for arbitration without a hearing under Rule 68 of the Dispute Resolution Practice Code, finding the application frivolous, vexatious, or commenced in bad faith due to the applicant's failure to participate.

The insurer did not seek expenses.