Rose Bilash

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including housekeeping and home maintenance benefits.

The insurer denied the claim and sought an orthopaedic examination under section 42 of the Statutory Accident Benefits Schedule.

The applicant refused to attend, arguing he had not yet applied for the benefit.

The insurer argued the applicant was disentitled for failing to attend the examination.

The arbitrator held that the applicant had not applied for the benefit at the time the examination was requested, as he had not submitted the required Application for Expenses and explicitly stated he had not applied.

Therefore, he was not required to attend the examination.

The issue of whether the applicant had a reasonable explanation for failing to apply within 30 days of receiving the forms was deferred to the main hearing.

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.

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

The parties engaged in settlement discussions, and the applicant's representative confirmed a settlement in writing.

The insurer subsequently sought an expense hearing, arguing it had not expressly withdrawn its claim for expenses.

The arbitrator found that a settlement of the issues had been reached, which implicitly included an agreement that each side would bear its own costs.

The arbitrator awarded the applicant $750 in expenses for the preliminary issue hearing but denied expenses for the arbitration hearing.

The insurer's claims for expenses and for the applicant's representative to be held personally liable were dismissed.

The insurer sought its arbitration expenses and assessment fee after the applicant's claim for statutory accident benefits was dismissed on the basis that no motor vehicle accident occurred.

The arbitrator found that the applicant falsely represented that an accident occurred and knowingly pursued a fraudulent claim, constituting an abuse of process.

The arbitrator awarded the insurer $3,388.50 in arbitration expenses and the $3,000 assessment fee.

The applicant sought accident benefits following an alleged motor vehicle accident on December 31, 2000.

The insurer denied the claim, arguing the accident did not occur.

At the arbitration hearing, the insurer presented expert evidence from an accident investigator who testified that the physical damage to the vehicles was inconsistent with the reported collision and matched pre-existing damage from 1997.

The arbitrator accepted the expert's unrebutted evidence, found that the applicant was not involved in the alleged accident, and dismissed the claim for accident benefits.