OFSCDRS 2016

The applicant's counsel brought a motion to be removed from the record after the applicant failed to communicate or provide instructions following mediation.

The arbitrator granted the motion to withdraw.

The insurer subsequently brought a motion to dismiss the arbitration as abandoned and vexatious, noting the applicant's failure to attend the pre-hearing or respond to communications.

The arbitrator found that the applicant had effectively abandoned his claims and that continuing the arbitration would be an abuse of process.

The arbitration was dismissed, and the applicant was ordered to pay the insurer's expenses fixed at $2,772.07.

The applicant was injured in a motor vehicle accident and applied for a determination of catastrophic impairment under the Statutory Accident Benefits Schedule.

The core issue was whether his mental and behavioural impairments, specifically his cannabis dependence and adaptation difficulties, constituted a marked impairment (Class 4).

The arbitrator found the applicant's evidence lacking in credibility and preferred the insurer's expert evidence, concluding that the applicant's impairments were only moderate (Class 3) and his combined whole person impairment did not meet the 55% threshold.

The application was dismissed, and the insurer was awarded partial expenses due to the applicant's conduct prolonging the proceeding.

The applicant, who was injured in a motor vehicle accident, brought a motion seeking the production of documents from the insurer ahead of an arbitration hearing.

The arbitrator found that all documents sought had already been produced, except for clarifications and documents concerning periodic payments of $30.00 and $45.00 related to a housekeeping benefit.

The insurer agreed to produce these documents if they existed.

The arbitrator ordered the insurer to produce any existing documentation regarding these payments by July 4, 2016.

The applicant failed to attend the scheduled arbitration hearing regarding statutory accident benefits.

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

The arbitrator found that the applicant had been notified of the proceedings and was aware that failure to attend would result in a motion to dismiss.

The application was dismissed, and the insurer was awarded $500 in expenses.

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

He sought arbitration for non-earner benefits.

The insurer raised a preliminary issue that the applicant had not mediated the issue of non-earner benefits, as the mediation report only referred to income replacement benefits.

The arbitrator held that mediation of the specific issue is a statutory precondition to arbitration under section 281(2) of the Insurance Act.

The arbitrator rejected the applicant's arguments regarding fundamental breach and relief from forfeiture, finding no jurisdiction to grant relief from forfeiture and that the mediation requirement is not an exclusion clause.

The application for arbitration was dismissed.

The appellant was injured in a motor vehicle accident on October 29, 2010, and claimed statutory accident benefits under a transitional policy.

The arbitrator held that interest on overdue benefits was payable at the reduced rate of 1% per month under the New Regulation.

On appeal, the Director's Delegate found that the arbitrator erred in law by failing to apply the specific transition provisions in the Old and New Regulations, which preserved the 2% per month interest rate for amounts determined under the Old Regulation.

The appeal was allowed, and the appellant was awarded interest at 2% per month, compounded monthly.

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

After her counsel was removed from the record, she failed to attend a scheduled pre-hearing teleconference.

The insurer brought a motion to dismiss the application for arbitration under Rule 68 of the Dispute Resolution Practice Code.

The arbitrator found that the applicant had abandoned her claim and dismissed the application, ordering her to pay $500 in expenses to the insurer.

Following the dismissal of the applicant's application for arbitration on a preliminary issue, the insurer sought its expenses of the proceeding.

The arbitrator found the insurer was entitled to its expenses as the successful party.

The arbitrator reduced the insurer's claimed legal fees, finding the involvement of four lawyers and a law clerk for a straightforward limitation period issue to be excessive and duplicative.

The insurer was awarded $3,459.39 in total expenses, inclusive of fees, disbursements, and HST.

The Insurer sought its expenses following a successful defence of the Applicant's claims for statutory accident benefits.

The Arbitrator found that the Applicant's conduct prolonged the proceedings through late production of evidence, failure to properly summon witnesses, and pursuit of unnecessary procedural aspects.

The Insurer claimed approximately $51,900 in expenses.

The Arbitrator reduced the claimed legal fees and disbursements, noting the lack of complexity and excessive claims for process service and court reporters.

The Applicant was ordered to pay the Insurer's expenses fixed at $13,400.

The appellant suffered a heart attack while driving, causing his van to crash and become stranded over a ditch.

The damage to the van prevented a bystander from immediately administering CPR, resulting in a delay in treatment and severe neurological impairment.

The arbitrator initially found the incident was not an 'accident' under the Statutory Accident Benefits Schedule, concluding the heart attack was an intervening event.

On appeal, the Director's Delegate reversed the decision, finding that the appellant's continued use of the vehicle delayed treatment and directly contributed to his impairment, satisfying the causation test for an accident.

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

The insurer initiated a Preliminary Issue Hearing to dismiss the application due to the insured's failure to attend insurer examinations.

Prior to the hearing, the insured attended the examination, rendering the preliminary issue moot.

The insurer sought its expenses for preparing for the hearing.

The Arbitrator reserved the issue of expenses to the arbitrator seized of the substantive arbitration, noting that the delay in attending the examination may be relevant to the final disposition.

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

After failing to participate in a pre-hearing discussion and the subsequent arbitration hearing, despite being provided notice, the Arbitrator dismissed the Application for Arbitration.

The Applicant was ordered to pay $500 in expenses to the Insurer.

The applicant was injured when he fell from a ladder, allegedly after a vehicle struck it.

The insurer denied statutory accident benefits on the basis that the incident was not a motor vehicle accident.

During the assessment phase, the insurer commissioned an engineering report.

The applicant brought a motion to compel production of the report.

The insurer claimed litigation privilege, arguing the report was prepared in anticipation of arbitration.

The arbitrator found that the report was commissioned during the good faith investigation phase, before litigation could be reasonably anticipated.

The insurer was ordered to produce the report.

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

After his legal counsel was removed from the record, the applicant failed to retain new counsel or attend the scheduled arbitration hearing despite receiving adequate notice.

The arbitrator dismissed the application for arbitration due to the applicant's non-attendance and awarded the insurer $1,500 in expenses for defending the claim.

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

After the applicant's representative was removed from the record, the applicant failed to attend the rescheduled arbitration hearing despite receiving notice.

The arbitrator dismissed the application for arbitration due to the applicant's failure to appear and present evidence.

The insurer was awarded $2,500 in expenses for preparation and attendance.

The applicant applied for statutory accident benefits following two motor vehicle accidents.

The parties were unable to resolve their disputes through mediation, and the applicant applied for arbitration.

At the scheduled arbitration hearing, the applicant failed to appear, although his representative was present.

The insurer brought a motion to dismiss the applications.

The arbitrator found that the applicant had been notified of the proceedings and failed to meet his onus of proof by not attending.

The applications for arbitration were dismissed, and the insurer was awarded $500 in expenses for each application.

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

After a breakdown in the solicitor-client relationship, the applicant's representative was removed from the record.

The applicant subsequently failed to attend the scheduled arbitration hearing and did not respond to the arbitrator's notice regarding the insurer's request to dismiss the application.

The arbitrator concluded that the applicant had abandoned her claim, rendering the proceeding frivolous and vexatious.

The application for arbitration was dismissed pursuant to Rule 68 of the Dispute Resolution Practice Code, and the applicant was ordered to pay $500 in expenses to the insurer.

The applicants sought accident benefits following a motor vehicle accident.

After failing to attend a pre-hearing discussion and losing contact with their legal representative, the representative brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship.

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

The arbitrator granted the representative's motion to be removed and dismissed the applications for arbitration with costs, noting the applicants' failure to participate or respond to notices.

The applicant was injured in a motor vehicle accident and sought income replacement benefits from her insurer.

The insurer denied the benefits, arguing her injuries fell within the Minor Injury Guideline.

The arbitrator found the applicant credible and accepted medical evidence that she suffered from Chronic Pain Syndrome as a result of the accident.

The arbitrator concluded the applicant suffered a substantial inability to perform the essential tasks of her employment for the first 104 weeks, and a complete inability to engage in any suitable employment thereafter.

The applicant was awarded ongoing income replacement benefits and interest on overdue payments.

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

After a breakdown in the solicitor-client relationship, the applicant's counsel was removed from the record.

The applicant failed to attend multiple pre-hearing discussions and the arbitration hearing itself.

As the applicant adduced no evidence to prove entitlement to the claimed benefits, all claims were dismissed.

The insurer was awarded $500 in expenses due to the applicant's failure to participate, which unduly prolonged the proceedings.