Santino Lofranco

The applicant sought a special award in an arbitration for statutory accident benefits, but the insurer prevailed.

The parties could not agree on expenses.

The arbitrator applied the criteria under section 12 of Regulation 664 and found the insurer was entitled to its expenses.

The arbitrator awarded the insurer $5,738.05, calculating the fees based on Legal Aid Rates and allowing for two days of hearing and preparation, noting the hearing was prolonged by the inexperience of the applicant's representatives.

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

The parties settled the claims for income replacement and medical benefits, leaving only the issue of whether the applicant was entitled to a Special Award under s. 282(10) of the Insurance Act for the insurer's initial denial of benefits.

The arbitrator found that the insurer acted reasonably at all relevant times based on the medical information available, which supported a theory that the applicant's impairments were due to pre-existing degenerative disc disease rather than the accident.

The claim for a Special Award was dismissed.