Ontario Financial Services Commission - Dispute Resolution Services

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

Following a breakdown in the relationship, the applicant's representative brought a motion to be removed from the record.

The insurer brought a motion to dismiss the arbitration due to the applicant's failure to participate.

The applicant did not attend the motions despite receiving notice.

The arbitrator granted the representative's motion to withdraw and dismissed the arbitration.

The appellant insurer sought leave to appeal a preliminary arbitration decision, which was rejected by the Director's Delegate.

The respondent insured subsequently sought his legal expenses for successfully resisting the leave application.

The Delegate found that the respondent was entirely successful and that the appeal had delayed the resolution of substantive issues.

The Delegate awarded the respondent his legal expenses, finding the claimed hourly rates and time spent to be reasonable, and fixed the costs at $4,317.64 inclusive of HST.

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

After failing to attend two pre-hearing conferences and the scheduled arbitration hearing, the applicant's counsel was permitted to withdraw from the proceeding.

As no one appeared on behalf of the applicant to tender evidence, the arbitrator dismissed the claims for non-earner and medical benefits.

The applicant was ordered to pay $1,500 for the insurer's arbitration expenses.

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

After her legal representative withdrew due to a breakdown in the solicitor-client relationship, the applicant failed to attend a pre-hearing discussion and the scheduled arbitration hearing.

As the applicant did not attend to present evidence, she failed to establish entitlement to the benefits claimed.

The arbitrator dismissed the claims and ordered the applicant to pay the insurer's arbitration expenses in the amount of $1,100.

The appellant insurer sought a stay of an arbitrator's decision which found that mileage and parking expenses incurred by the respondent's spouse while providing attendant care services constituted an economic loss under the Statutory Accident Benefits Schedule.

The Director's Delegate applied the Armstrong criteria and denied the stay, finding that the appellant failed to provide evidence of hardship if the stay were refused, and noting the significant prejudice to the respondent caused by the delay in receiving benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, claiming he sustained a catastrophic impairment due to a mental disorder.

The insurer argued the mental disorder was genetically based and not caused by the accident.

The Arbitrator found that the accident caused the applicant's mental disorders, which resulted in a marked impairment of his ability to function, meeting the definition of catastrophic impairment.

The applicant was awarded attendant care benefits at a reduced rate, as he did not require round-the-clock care.

Claims for Botox injections and a special award were dismissed.

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

After mediation failed, the applicant applied for arbitration.

The applicant's counsel withdrew from the record due to an inability to obtain instructions.

The applicant subsequently failed to attend a pre-hearing and a preliminary issue hearing, despite receiving proper notice.

The arbitrator found that the applicant had abandoned the proceeding and dismissed the application for arbitration.

No costs were awarded.

The appellant, who was injured in a motor vehicle accident at age 10, appealed an Arbitrator's decision denying him non-earner benefits (NEBs) under the SABS-1996.

The Arbitrator found that the appellant did not suffer a complete inability to carry on a normal life within 104 weeks of the accident, nor when he turned 16.

The appellant argued that the insurer's failure to provide proper notices of refusal procedurally entitled him to benefits.

The Director's Delegate upheld the Arbitrator's decision, confirming that under the Court of Appeal's decision in Stranges, procedural breaches by an insurer do not automatically entitle an insured to benefits without proving substantive entitlement.

The appeal was dismissed.

The applicants claimed statutory accident benefits following a reported hit-and-run motor vehicle collision.

The insurer denied the claims, arguing the applicants were not involved in an 'accident' as defined in the Schedule and putting them to strict proof that the collision occurred as reported.

Following a preliminary issue hearing, the arbitrator found the applicants' evidence credible and corroborated by circumstantial evidence, while finding the insurer's accident reconstruction evidence unpersuasive.

The arbitrator concluded that the applicants were involved in an accidental collision and were therefore involved in an 'accident' under subsection 2(1) of the Schedule.

Following the dismissal of the applicant's claim for statutory accident benefits, the insurer sought its expenses for the arbitration.

The applicant had failed to attend the hearing and her claim was found to have been concocted.

The arbitrator reviewed the insurer's bill of costs, which included legal fees capped at the legal aid tariff rate and disbursements including an engineering report and travel expenses.

The arbitrator found the claimed expenses reasonable and ordered the applicant to pay $4,865.43 to the insurer.

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

The insurer disputed entitlement on the basis that the applicant was not involved in an "accident" as defined in the Schedule.

The applicant failed to participate in the arbitration process and did not attend the hearing despite receiving proper notice.

The arbitrator dismissed the arbitration due to the applicant's failure to tender evidence and ordered the applicant to pay $500 in expenses to the insurer.

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

The insurer disputed entitlement on the basis that the applicant was not injured in an 'accident' as defined in the Schedule.

The applicant failed to participate in the arbitration process and did not attend the hearing despite receiving proper notice.

The arbitrator dismissed the arbitration due to the applicant's failure to tender evidence and ordered the applicant to pay $500 in expenses to the insurer.

The insurer, having been entirely successful on the claimant's appeal of an arbitration decision denying further statutory accident benefits, requested an appeal expenses hearing.

The claimant's representative engaged in inappropriate communications regarding settlement discussions and failed to provide responding submissions, citing an unrelated court action.

The Director's Delegate found the insurer entitled to its reasonable appeal expenses based on its degree of success.

The insurer was awarded $5,000 inclusive of disbursements and HST, reflecting the extra time required due to the challenging conduct of the claimant and her representative.

The applicant sought statutory accident benefits following a motor vehicle accident but subsequently failed to participate in the arbitration proceedings.

Her legal counsel was removed from the record after being unable to contact her, and the applicant's son later left a voicemail indicating she did not want to proceed with her claim.

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

The insurer was awarded $250 in expenses for having to prepare for and participate in the proceedings.

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

After filing an Application for Arbitration, the applicant failed to participate in the proceedings or communicate with her counsel.

The applicant's counsel brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, and the insurer moved to dismiss the application with expenses.

The arbitrator granted the motion to remove counsel, dismissed the application as frivolous and vexatious due to the applicant's failure to participate, and awarded the insurer $250 in expenses.

The applicant failed to participate in the arbitration proceedings or respond to communications after her legal counsel was removed from the record.

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

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

The insurer was awarded $500 in throw-away costs.

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

After the applicant's legal representatives lost contact with him and were removed from the record, the applicant failed to attend a pre-hearing resumption and a subsequent preliminary issue hearing.

The insurer brought a motion to dismiss the application.

The arbitrator granted the motion and dismissed the application for arbitration pursuant to Rule 68 of the Dispute Resolution Practice Code.

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

The insurer denied various benefits, and the applicant applied for arbitration.

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

The arbitrator proceeded in the applicant's absence.

The applicant failed to meet the burden of proof to establish entitlement to benefits.

The claims were dismissed, and the applicant was ordered to pay the insurer's expenses of the arbitration fixed at $1,500.