Other Tribunals - OFSCDRS

The parties both brought motions to vary interim production orders made during a pre-hearing discussion regarding a statutory accident benefits dispute.

The insurer sought to exclude certain sources of records because the applicant had commenced a tort action against them, while the applicant sought specific document production due to mistrust of the insurer.

The arbitrator dismissed both motions, finding she lacked jurisdiction to vary interim orders under Rule 61.2 of the Dispute Resolution Practice Code.

Even if jurisdiction existed, the arbitrator noted she would have dismissed the motions on their merits, as the tort action was not material to the arbitration and the applicant's mistrust did not justify anticipating a breach of the production order.

The applicant sought expenses following a successful preliminary issue hearing regarding statutory accident benefits.

The arbitrator awarded the applicant $19,629.68 in expenses, inclusive of fees, disbursements, and HST, applying a 1:4 ratio for hearing to preparation time and utilizing the legal aid hourly rate.

The insurer sought expenses following a successful arbitration where no accident benefits were awarded to the three applicants.

The applicants argued that no costs should be awarded against two of the applicants as they were persons under a disability.

The arbitrator found that the estate was legally responsible for costs, but declined to award costs against the autistic applicant, as there was no evidence of a substitute decision-maker agreeing to be bound for costs.

The arbitrator awarded proportionate costs to the insurer against the remaining two applicants, applying legal aid rates.

The appellant appealed an arbitrator's decision denying his claims for attendant care and housekeeping benefits.

The appellant failed to order the hearing transcript or deliver written submissions despite multiple extensions and warnings.

The Director's Delegate proceeded with the appeal under Rule 58.1 and dismissed it, finding that the Notice of Appeal made vague allegations of bad faith without identifying any errors of law, as required by section 283(1) of the Insurance Act.

The self-represented applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The arbitrator found that the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his pre-accident employment as a self-employed contractor.

The medical evidence submitted did not specifically address the essential tasks test.

Furthermore, financial evidence indicated the applicant's business generated more revenue post-accident.

The claims for IRBs and interest were dismissed.

The applicant sought to withdraw her application for arbitration of accident benefits three days before the scheduled hearing.

The insurer requested that the withdrawal be with prejudice and sought its expenses for the proceeding.

The arbitrator permitted the withdrawal without prejudice but awarded expenses to the insurer, finding that the insurer was entirely successful as the applicant did not proceed with her claims.

After reducing the insurer's claimed legal fees for excessive hours and duplication of effort, the arbitrator awarded the insurer $42,134.02 in total expenses.

The Applicant sought a determination that she was catastrophically impaired following a 2002 motor vehicle accident.

At the scheduled arbitration hearing, the Applicant requested an adjournment to obtain expert reports, as she had no medical evidence to rebut the Insurer's assessments.

The Arbitrator denied the adjournment, finding that a further delay was unreasonable and unfair to the Insurer.

As the Applicant acknowledged she had no evidence to support her claim, the Application for Arbitration was dismissed.

The Insurer was awarded $4,015.54 in expenses.

The insurer appealed an arbitrator's decision regarding jurisdiction to calculate interest and the quantum of expert witness expenses.

The parties agreed on the expense amounts and that the arbitrator had jurisdiction to determine interest.

The Director's Delegate resolved the remaining interest calculation disputes, finding that no interest accrues on a special award prior to the date of the order, and that an earlier expense award against the claimant could not be set off against benefits until the final order determining the cause was issued.

The appellant's appeal of an arbitrator's order was previously dismissed.

The respondent insurer sought its expenses of the appeal.

The Director's Delegate considered the criteria under section 12(2) of the Expense Regulation, noting the respondent's complete success and the conduct of the appellant's representative which unnecessarily prolonged the hearing and post-hearing process.

The Delegate rejected the appellant's arguments regarding proportionality and access to justice, finding them inapplicable or outweighed by the representative's conduct.

The appellant was ordered to pay the respondent's appeal expenses fixed at $3,500 inclusive of disbursements and HST.

The Applicant sought to withdraw his application for arbitration at the Financial Services Commission of Ontario shortly before a rescheduled hearing, citing a desire to avoid a multiplicity of proceedings given parallel Superior Court actions.

The Insurer objected and sought its expenses.

The Arbitrator found the late withdrawal unjustified and awarded the Insurer $5,500.00 in expenses for costs thrown away, applying principles of reasonableness and consumer protection.

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

At the arbitration hearing, the applicant failed to appear, and her representative brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, having lost contact with the applicant for several months.

The arbitrator granted the representative's motion to withdraw and subsequently dismissed the application for arbitration due to the applicant's absence.

The insurer was awarded expenses of $4,500 plus HST, as the applicant's failure to complete a prior tentative settlement and unexplained absence caused the insurer to incur unnecessary preparation costs.

Following an arbitration hearing where the insurer was substantially successful, the insurer sought its expenses.

The arbitrator found that the applicant's claims for income replacement and medical benefits were vexatious and improper, and that the applicant had unduly prolonged the proceedings by failing to produce documents.

The applicant was ordered to pay the insurer's expenses and disbursements for the hearing, excluding the pre-hearing conference, fixed at $23,055.31.

Each party was ordered to bear their own expenses for the expense hearing.

The parties sought a determination of expenses following an arbitration decision where the applicant was successful on minor claims but the bulk of her claims were denied.

The insurer sought expenses of $28,382.37, arguing it was largely successful.

The applicant argued each party should bear its own costs, noting she recovered approximately $12,750.00 and raised novel issues regarding the deductibility of payments to a domestic worker and the interpretation of s. 3(8) of the Schedule.

The arbitrator agreed with the applicant, finding that her arguments were novel and not vexatious or improper.

The arbitrator ordered that each party bear their own costs of the arbitration.

Following an arbitration where the applicant was found catastrophically impaired but was largely unsuccessful on the quantum of attendant care benefits, the parties disputed the entitlement to and quantum of expenses.

The arbitrator awarded the applicant his reasonable expenses but reduced them by one-third to reflect the insurer's success on the significant issue of attendant care quantum.

After assessing the claimed legal fees and disbursements, the arbitrator ordered the insurer to pay the applicant $41,039.34 for expenses.

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

The applicant applied for arbitration but withdrew the application the day before the scheduled four-day hearing.

The insurer sought its expenses for preparing for the hearing.

The arbitrator found that the insurer was entitled to prepare for the hearing as there was no clear indication it would not proceed until the day before.

The arbitrator awarded the insurer its expenses in the amount of $12,751.76, reducing some witness preparation fees that exceeded the maximum allowed under the Dispute Resolution Practice Code.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic and massage treatment.

The insurer denied the treatment plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that she had reached maximum recovery.

The arbitrator found that the applicant suffered from chronic pain syndrome exacerbated by pre-existing arthritis and osteoporosis, placing her injuries outside the MIG.

The arbitrator preferred the evidence of the applicant's family physician over the insurer's orthopaedic assessor, finding the treatment plan reasonable and necessary.

The insurer was ordered to pay the disputed medical benefits with interest.

The insureds sought to add new issues regarding non-earner benefits and assessment costs to their existing FSCO arbitration proceedings after April 1, 2016, the date jurisdiction over accident benefits disputes transitioned to the Licence Appeal Tribunal (LAT).

The Arbitrator allowed the issues to be added.

On appeal, the Director's Delegate reversed the decision, applying prior jurisprudence that adding issues to an existing arbitration is equivalent to commencing a new arbitration.

Because the new issues did not necessarily flow from the existing issues, they could not be added to the FSCO proceedings after the transition date and must be brought before the LAT.

The respondent sought appeal expenses of $3,500 following the dismissal of the appellant's appeal.

The parties agreed on the quantum but disputed the timing of payment.

The appellant argued payment should be delayed pending its application for judicial review, or awarded in the cause.

The Director's Delegate ordered the expenses payable forthwith, noting that a judicial review does not automatically stay the process and the respondent was entirely successful on a discrete issue.

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

The insurer terminated attendant care and housekeeping benefits, leading to a settlement and release.

The release included a 'without prejudice' clause preserving the applicant's right to claim post-104 week benefits if determined to be catastrophically impaired.

The insurer raised a preliminary issue arguing the applicant was barred from claiming these benefits due to the limitation period and the settlement.

The arbitrator found the release clear and unambiguous, holding that it did not preclude the applicant from proceeding with his claim for post-104 week benefits.

Following the dismissal of the applicant's claim for statutory accident benefits, the insurer sought its arbitration expenses of $16,957.85, arguing they should be awarded personally against the applicant's counsel due to delayed communication and late disclosure.

The arbitrator declined to award costs personally against counsel, finding the conduct did not meet the threshold of extreme caution required by Young v. Young.

However, the arbitrator found the insurer was entitled to its reasonable expenses from the applicant, fixing the amount at $11,000 inclusive of disbursements and taxes, based on the applicable Legal Aid tariff rates.