Other Tribunals - OFSCDRS

The applicant sought accident benefits following a motor vehicle accident.

Her counsel brought a motion to be removed from the record due to a breakdown in the lawyer-client relationship and an inability to communicate.

The arbitrator granted the motion to remove counsel.

The applicant subsequently confirmed she did not wish to obtain new representation and wanted to cancel the arbitration.

The insurer brought a motion to dismiss the application.

The arbitrator dismissed the application for arbitration without costs.

The insurer, Allstate, sought its expenses after successfully defending an appeal brought by the insured regarding statutory accident benefits.

The Director's Delegate found that Allstate was entirely successful on the appeal and that the appeal did not raise any novel issues of general importance, but rather turned on specific facts.

The Delegate rejected the insured's arguments that the hours claimed by Allstate's counsel for reporting to the client and preparing for the hearing were disproportionate.

Allstate was awarded its legal fees and disbursements fixed at $2,164.38.

The parties sought costs following an arbitration hearing where the insurer successfully refuted the applicant's claims for statutory accident benefits.

The insurer also sought to make the applicant's representative personally liable for costs, which was dismissed on a summary judgment motion.

The arbitrator awarded the insurer $4,509.21 in expenses for the arbitration hearing, finding its claimed hours excessive and applying a 1:1 ratio for preparation to hearing time.

The arbitrator awarded the representative $500 for the summary judgment motion, finding the insurer's conduct unreasonable.

The arbitrator declined to allow the insurer to set off its costs award against the amount owed to the representative.

The applicant was completely successful in an arbitration regarding statutory accident benefits.

She sought her expenses for the arbitration hearing.

The arbitrator found that the applicant was entitled to her expenses, noting that the hearing involved a novel issue and required interpretation for witnesses, which increased preparation time.

The arbitrator awarded the applicant $45,470.25 for legal fees and $11,853.65 for disbursements, for a total of $57,323.90 inclusive of GST.

The parties settled a dispute regarding statutory accident benefits, but a disagreement arose over the execution of the release.

The insurer required the insured's counsel to sign a certificate confirming the release was explained, which the insured refused on the basis of solicitor-client privilege.

The arbitrator found a binding settlement existed, held the insurer's requirement was arbitrary, and ordered payment of the settlement funds plus a special award for unreasonable withholding.

On appeal, the Director's Delegate upheld the finding of a binding settlement and the award of interest, noting that a witnessed release is standard practice.

However, the Delegate rescinded the special award, finding that the insurer's attempt to negotiate the release terms did not constitute unreasonable behaviour warranting a special award.

The appeal was allowed in part.

The applicant claimed statutory accident benefits following an alleged motor vehicle accident.

The insurer raised a preliminary issue regarding whether an 'accident' occurred.

After multiple adjournments and the removal of the applicant's counsel, the applicant failed to attend the peremptory preliminary issue hearing.

The arbitrator proceeded in her absence pursuant to the Statutory Powers Procedure Act and the Dispute Resolution Practice Code.

The application for arbitration was dismissed as the applicant failed to establish she was injured in an accident.

The applicant sought to schedule an arbitration hearing as soon as possible, suggesting January 2009.

The insurer's counsel was unavailable for those dates and requested March 2009.

The arbitrator held that the scheduling of the hearing is not strictly dependent on the availability of the insurer's counsel, emphasizing the statutory goal of a prompt and inexpensive resolution.

The arbitrator ordered that the hearing remain scheduled for January 12, 2009, noting the applicant's willingness to consent to an adjournment if the insurer's counsel was actually engaged in conflicting judicial commitments at that time.

The insurer brought a motion for the production of a Crown Brief and police records relating to drug trafficking charges against the applicant, arguing the records were relevant to the applicant's entitlement to income replacement benefits.

The applicant's counsel did not oppose the motion and subsequently sought to be removed from the record due to a breakdown in the solicitor-client relationship.

The arbitrator granted the unopposed production motion and ordered the applicant's counsel removed from the record.

The applicant was injured in a motor vehicle accident and received income replacement benefits for six years.

The insurer then terminated the benefits and sought repayment, alleging the applicant was not employed as claimed.

On a preliminary issue, the arbitrator held that, as a matter of law, an insurer can be estopped from challenging an insured's entitlement to and quantum of income replacement benefits on grounds related to pre-accident employment, despite the dispute resolution and repayment provisions of the Insurance Act and the Statutory Accident Benefits Schedule.

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

The applicant failed to attend the arbitration hearing on two separate occasions.

The arbitrator granted the insurer's motion to dismiss the application for arbitration.

The arbitrator also awarded the insurer its expenses of the proceeding, assessing costs at $4,836.92 based on the applicant's failure to participate, which unnecessarily prolonged the process.

Following a decision on the merits where the applicant was partially successful in claiming weight training and psychological assessment expenses, the parties could not agree on the costs of the arbitration.

The arbitrator applied the criteria in section 12(2) of the Expense Regulation and found that because success was divided and no party engaged in conduct that prolonged the proceeding, each party should bear its own expenses.

The insurer's request to recover its $3,000 assessment cost was also denied as it is not a recoverable expense under the regulation.

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

At the arbitration hearing, the insurer brought a preliminary motion to exclude the applicant's representative, a statutory accident benefits (SABS) representative, alleging an undisclosed conflict of interest.

The arbitrator found that the representative had a business relationship with a diagnostic facility to which he referred the applicant, creating an apprehension that he could receive a financial benefit.

The arbitrator also noted the representative's inappropriate conduct at the hearing and failure to promptly notify the insurer of his retainer.

The representative was excluded from the proceedings and ordered to personally pay $500 in expenses for causing unreasonable delay.

The applicant, injured in a motor vehicle accident, sought statutory accident benefits and brought a motion for the production of the insurer's complete file.

The insurer claimed litigation and solicitor-client privilege over portions of the file but failed to provide supporting evidence.

The arbitrator ordered the production of documents created before May 1, 2000, finding no evidence that litigation was contemplated before the first application for arbitration.

Documents created after that date and those claiming solicitor-client privilege were ordered to be provided to the arbitrator in a sealed envelope for review.

The insurer brought a motion to dismiss the applicant's arbitration for statutory accident benefits and sought costs against the applicant's representative personally, following the representative's failure to comply with conditions attached to a previously granted adjournment.

The arbitrator declined to dismiss the arbitration, finding that the applicant was not responsible for the representative's conduct and the proceeding was not frivolous or vexatious.

However, the arbitrator found that the representative failed without reasonable explanation to comply with the adjournment conditions and caused the insurer to incur expenses without reasonable cause.

The representative was ordered to personally pay $500 in costs to the insurer.

Following a decision denying the applicant's claim for income replacement benefits, the insurer sought an award of its arbitration expenses, alleging the applicant caused delays and called unnecessary witnesses.

The arbitrator found no evidence of intentional obstruction or neglect by the applicant, noting the insurer raised its successful exclusion defence only a month before the hearing.

The arbitrator concluded that the applicant acted in good faith and ordered each party to bear its own costs.

The applicant sought expenses following a successful arbitration claim for income replacement benefits against the insurer.

The arbitrator found the applicant was entitled to his reasonable arbitration expenses due to his success on the major issue and the professional conduct of the hearing.

After reviewing the claimed hourly rates, allowable hours, and disbursements, the arbitrator awarded the applicant $8,954.64 inclusive of GST.

The applicant claimed statutory accident benefits following a motor vehicle accident and applied for arbitration after mediation failed.

The applicant and her representatives failed to attend the scheduled arbitration hearing, failed to comply with undertakings, and failed to serve documents.

The arbitrator dismissed the application as abandoned.

Finding that the applicant commenced the arbitration with no intention of proceeding, which constituted an abuse of process designed to pressure the insurer into settlement, the arbitrator ordered the applicant to pay the insurer $3,000 under section 282(11.2) of the Insurance Act, plus the insurer's expenses thrown away.

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

After the insurer terminated benefits, an application for arbitration was filed on his behalf.

However, the applicant had died prior to the application being issued, and an estate trustee had not yet been appointed.

The insurer argued the application was a nullity.

The arbitrator held that the doctrine of relation back applied to contractual claims for insurance benefits, allowing the subsequently appointed estate trustee to validate the application.

Alternatively, Rule 9.03 of the Rules of Civil Procedure applied to save the proceeding.

The preliminary issue was resolved in favour of the estate, allowing the arbitration to proceed.

An application for arbitration for statutory accident benefits was filed in the name of a deceased insured by a law firm retained by a treatment provider, without authorization from the deceased's estate.

The arbitrator held that the application was a nullity because an action cannot be commenced in the name of a deceased person without the involvement of a duly appointed estate representative.

The agency relationship between the deceased and the treatment provider or law firm, if any existed, terminated upon the insured's death.

The insurer brought a preliminary motion to dismiss the arbitration because the applicant failed to comply with a prior order requiring him to withdraw his related court action forthwith.

The applicant's counsel had sought the insurer's consent to dismiss the action without costs, which the insurer refused.

The arbitrator found that the applicant's failure to withdraw the action was based on a misunderstanding of the order rather than tactical reasons.

The motion to dismiss the arbitration was denied, on the condition that the applicant immediately bring a motion to dismiss the court action.