Paul Caprani

The applicant sought accident benefits after his vehicle struck an unknown object on the highway, causing mechanical failure and alleged soft tissue injuries.

The insurer denied the claim, arguing no accident occurred and the applicant was not injured, relying on an engineering expert and the applicant's initial statements.

The arbitrator found the applicant's version of events was corroborated by reliable records and that his initial statements were affected by a language barrier.

The arbitrator concluded the applicant suffered an impairment as a result of the accident and ordered the insurer to pay $500 in expenses for the preliminary issue hearing.

The applicant sought statutory accident benefits after being assaulted by a co-worker who dragged him out of his truck and threw him against it.

The insurer denied benefits on the basis that the incident was not an 'accident' under section 2 of the Statutory Accident Benefits Schedule.

The arbitrator agreed, finding that the applicant's injuries were caused by the assault, not by the use or operation of the automobile.

As there was no accident, the insurer was not required to pay benefits pending dispute resolution under subsection 59(5).

The applicant was involved in two motor vehicle accidents in April 2000.

She applied for statutory accident benefits from RBC Insurance for the first accident and from TTC Insurance for the second.

TTC argued that the applicant was required to claim benefits from RBC as the spouse of a named insured under section 268(5) of the Insurance Act.

The arbitrator held that the issue of whether the applicant was a spouse under the RBC policy was a priority dispute outside the jurisdiction of the Financial Services Commission of Ontario.

Pending resolution of the priority dispute in the proper forum, TTC, as the first insurer to receive the completed application for the second accident, was responsible for paying the benefits.

The applicant was injured when he tripped on a groove in the pavement of a parking lot after unloading groceries from the trunk of his car.

He applied for statutory accident benefits, which the insurer denied on the basis that the incident was not an 'accident' under the Schedule.

The arbitrator found that while the use of the vehicle brought the applicant to the location, the direct cause of the injuries was a new and independent source, namely the cracked pavement.

The claim for accident benefits was dismissed.