Phil Bouranov

The applicants were injured in a motor vehicle accident and applied for statutory accident benefits from Wawanesa.

Wawanesa denied coverage, arguing the applicants were not insured under a policy with them at the time of the accident.

On a preliminary issue hearing, the arbitrator found that she had jurisdiction to determine whether Wawanesa was an insurer with an obligation to pay benefits.

The arbitrator also found that there was a sufficient nexus between the applicants and Wawanesa, and that Wawanesa was obligated to respond to the applicants' claim for accident benefits pending the resolution of any dispute under the Disputes Between Insurers process.

The applicant was injured in a motor vehicle accident while driving a borrowed, uninsured vehicle.

She applied for statutory accident benefits from the insurer, claiming the vehicle's owner had obtained an oral agreement for coverage from the insurer prior to the accident.

The insurer denied coverage, arguing there was no contract of insurance.

The arbitrator found that there was a binding oral agreement between the vehicle owner and the insurer, establishing a sufficient nexus for the applicant to claim benefits.

The arbitrator ruled the applicant was entitled to coverage under section 268 of the Insurance Act, but declined to order interim benefits as the applicant had not established entitlement or urgency.

Following an arbitration decision regarding statutory accident benefits where the applicant was only successful in recovering $585 for an occupational therapy assessment, both parties sought their expenses of the proceeding.

The arbitrator considered the criteria under Rule 73.2 of the Dispute Resolution Practice Code.

Although the insurer had made an offer to settle that exceeded the applicant's recovery, the offer required a full and final release of all claims, which the arbitrator found to be a significant impediment to awarding expenses against the insured person.

Taking into account systemic considerations designed to facilitate access to speedy adjudication, the arbitrator ordered that each party bear its own expenses.

The applicants were injured in a motor vehicle accident and sought statutory accident benefits for caregiving, housekeeping, and medical devices.

The insurer denied the claims.

At arbitration, the arbitrator found the applicants' evidence lacked credibility and was contradicted by medical certificates and school records.

The applicants failed to establish that they suffered impairments substantially preventing them from performing their pre-accident activities, or that the claimed expenses were reasonable, necessary, and actually incurred.

All claims for benefits and a special award were dismissed.