Other Tribunals - OFSCDRS

The Insurer brought a motion to address the Applicant's failure to produce documents despite an undertaking and a prior order.

The Arbitrator stayed the arbitration proceeding until the Applicant complied or made best efforts to obtain the documents.

Furthermore, the Arbitrator found that the Applicant's paralegal representative failed to understand the duties of an advocate, caused unreasonable delay, and made a spurious claim for expenses.

Consequently, the representative was excluded from the hearing pursuant to section 23(3) of the Statutory Powers Procedure Act and ordered to personally pay $300 in costs to the Insurer.

The applicant's claim for death benefits following the death of her daughter in a motor vehicle accident was previously dismissed because she failed to establish financial dependence.

In this subsequent decision on expenses, both parties sought their costs of the arbitration.

Applying the criteria under Rule 75.2 of the Dispute Resolution Practice Code, the arbitrator awarded reasonable expenses to the insurer.

The arbitrator noted that while the applicant proceeded efficiently and honestly believed in the merits of her sensitive case, the insurer was entirely successful on the principal issue and no novel issues were raised.

The applicant sought medical, caregiver, and housekeeping benefits following two motor vehicle accidents.

Her claims were dismissed at the main arbitration hearing.

The insurer sought its arbitration expenses based on its success.

The applicant argued that a preliminary issue was novel and that she had made an offer to settle on the eve of the hearing.

The arbitrator found that the offer to settle was open for only 17 minutes and gave it no weight.

The arbitrator also found that the applicant's claim raised fundamental questions from the outset that remained unanswered.

The applicant was ordered to pay the insurer's arbitration expenses, assessed at $13,864.45.

Following a substantive arbitration decision regarding statutory accident benefits, the parties sought a determination on expenses.

Mr. Narain was largely successful in his application and had made a reasonable settlement offer; he was awarded his arbitration expenses of $7,624.83.

Ms. Mangroo was completely unsuccessful in her application, and her settlement offer was deemed unreasonable; consequently, she was ordered to pay the insurer's expenses of $5,233.67.

The arbitrator applied the exhaustive criteria under the amended Expense Regulation, declining to consider public policy arguments regarding financial hardship.

The insurer brought a motion for the production of documents from third parties in a dispute over statutory accident benefits arising from a motor vehicle accident.

The insurer sought clinical notes and records from the applicant's family doctor, income tax returns from Revenue Canada, and a letter from the applicant's accountant.

The arbitrator found that the insurer had made reasonable efforts to obtain the documents, the third parties had been properly served, and the documents were relevant to the applicant's claims for income replacement and other benefits.

The motion was granted, and the third parties were ordered to produce the requested documents at the insurer's expense.

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

After failing to resolve disputes through mediation, he applied for arbitration.

The applicant failed to comply with a prior order to produce documents and sign authorizations.

The arbitrator removed the applicant's former representative from the record at his request and ordered the arbitration stayed until the applicant complied with the production order.

An arbitration application was submitted to the Financial Services Commission of Ontario in the applicant's name by a paralegal firm.

The applicant later stated he had not authorized the proceeding.

The insurer sought its expenses for responding to the unauthorized application.

The arbitrator found that the paralegal commenced the proceeding without the applicant's authority and caused the insurer to incur expenses without reasonable cause.

The application was withdrawn, and the paralegal was ordered to personally pay the insurer's expenses pursuant to section 282(11.2) of the Insurance Act.

The applicant sought to withdraw her application for arbitration at the Financial Services Commission of Ontario in order to pursue her claims in the Superior Court of Justice.

The insurer opposed the withdrawal but requested costs, including costs against the applicant's counsel personally, if the withdrawal was granted.

The Arbitrator permitted the withdrawal on the condition that the applicant cannot re-apply for arbitration on the same issues.

The Arbitrator awarded $500 in costs to the insurer, payable by the applicant, finding the arbitration application was unnecessary given the subsequent choice to proceed in court.

The request for costs against counsel personally was dismissed due to a lack of evidence regarding who made the strategic decisions.

In a pre-hearing dispute over document production for a statutory accident benefits arbitration, the applicant sought the insurer's post-mediation adjuster's notes, while the insurer sought the clinical notes of the applicant's treating psychiatrist.

The arbitrator held that mediation serves as a convenient dividing line for when parties are in an adversarial position, but litigation privilege does not automatically attach to all post-mediation adjuster's notes.

The arbitrator reviewed the notes and ordered production of those not protected by litigation or solicitor-client privilege.

The arbitrator also ordered the applicant to produce the psychiatrist's clinical notes, finding them relevant and noting no evidence that disclosure would harm the patient, but restricted the insurer from releasing them outside the health care practitioners involved in the arbitration.

The applicant sought to withdraw his application for arbitration regarding statutory accident benefits after the insurer paid the outstanding treatment provider accounts.

The insurer opposed an unconditional withdrawal, seeking its expenses.

The arbitrator allowed the withdrawal but ordered expenses of $1,566 payable to the insurer, finding that the applicant's representative unreasonably delayed in responding to the insurer's notification of settlement, which unnecessarily prolonged the proceeding.

The insurer sought to add a repayment issue to the arbitration.

The applicant's representative refused to consent, claiming the issue was unmeritorious and statute-barred, but provided no evidence or detailed submissions.

The arbitrator found that the insurer's claim was not plainly and obviously devoid of merit and that adding the issue would avoid a multiplicity of proceedings.

The arbitrator allowed the insurer to amend its response to include the repayment issue and ordered the applicant to pay $250 in expenses due to the representative's contumacious refusal to consent.

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

Following mediation, the mediator's report noted an agreement that the parties' accountants would meet to discuss quantum, and the applicant would not proceed to arbitration before a reasonable attempt was made to resolve the issue.

The meeting never took place, and the applicant applied for arbitration.

The insurer brought a motion to stay the arbitration, arguing the agreement was a condition precedent.

The arbitrator dismissed the motion, finding that the applicant made reasonable attempts to arrange the meeting, the agreement lacked consideration as the insurer was already obligated to review the claim, and the agreement was void under section 279(2) of the Insurance Act for restricting the right to arbitrate.

The applicant's representative requested an adjournment of the arbitration hearing due to his client's absence and his failure to summons medical witnesses.

The arbitrator granted the adjournment but reserved on the issue of expenses.

The arbitrator found that the representative's lack of timely preparation caused expenses to be incurred without reasonable cause.

Pursuant to section 282(11.2) of the Insurance Act, the arbitrator ordered the representative to personally pay the insurer's costs thrown away, assessed at $819.96.

The insurer brought a procedural motion seeking to compel the applicant to produce two doctors for cross-examination, after the applicant identified them as witnesses at the pre-hearing but later decided to rely only on their reports.

The arbitrator held that the applicant had a duty to inform the insurer of the change in strategy as early as possible to protect the insurer's right to cross-examine.

The hearing was adjourned to allow the doctors to be summoned.

Other procedural issues regarding late delivery of a videotape and failure to provide expert qualifications were rendered moot by the adjournment.

The parties were ordered to bear their own expenses due to the insurer's intentional disregard of the rule regarding videotape delivery.

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

A dispute arose regarding entitlement to further treatment and housekeeping assistance.

At the scheduled arbitration hearing, the insurer sought a ruling on the consequences of the applicant's expert witnesses being unavailable for cross-examination.

The arbitrator found that the hearing could not proceed fairly without the experts or by excluding their evidence, which would likely result in dismissal.

The arbitrator adjourned the hearing and ordered the applicant to pay $300 in costs to the insurer for the unnecessary expense incurred.

The applicants claimed they were injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer denied the claims, alleging the accident did not occur.

The applicants failed to attend the arbitration hearing.

Relying on the insurer's expert evidence in accident reconstruction, which demonstrated that the physical damage to the vehicles was inconsistent with the applicants' description of the collision, the arbitrator concluded that the accident did not occur.

The claims for statutory accident benefits were dismissed.

The applicant sought payment of legal expenses following an arbitration regarding statutory accident benefits.

The insurer argued the applicant was only entitled to half his expenses due to divided success.

The arbitrator found the applicant was the successful party overall and entitled to his full reasonable legal expenses.

The arbitrator assessed the legal fees based on a reasonable preparation-to-hearing ratio and allowed an hourly rate of $150 for counsel.

The applicant was awarded $38,409.44 in legal expenses and disbursements.

The applicant's counsel brought a motion to be removed as counsel of record following a dispute with the applicant over the conduct of the arbitration.

The applicant opposed the motion and requested her file.

The arbitrator granted the motion, removing counsel from the record, and ordered counsel to release the file to the applicant upon payment of outstanding disbursements.

Following a preliminary issue hearing where it was determined that the applicants were not involved in a motor vehicle accident, the insurer sought its expenses.

The arbitrator found that the insurer was entirely successful and that the applicants' failure to make reasonable efforts to obtain new representation had prolonged the proceedings.

The applicants were ordered to jointly and severally pay the insurer's legal fees and disbursements, assessed at $7,373.11 based on Legal Aid Tariff rates.

The insurer brought a motion to dismiss the insured's arbitration application on the basis that the parties had reached a full and final settlement at a private mediation.

The insured, who was self-represented on the motion but had counsel at the mediation, argued she was brain-injured and pressured into an improvident settlement.

The arbitrator found no compelling evidence to rebut the statutory presumption of capacity and no evidence of illegitimate pressure amounting to economic duress.

The settlement complied with the Settlement Regulation, and the insured failed to rescind it within the statutory cooling-off period.

The motion was granted and the arbitration dismissed.