Stephen B. Abraham

The plaintiffs obtained a judgment against a bankrupt property maintenance company for injuries sustained in a slip and fall.

They subsequently brought an action against the company's insurer under s. 132 of the Insurance Act.

The insurer argued it was not liable because the insured failed to provide notice of the claim.

The Court of Appeal held that notice provided by a co-defendant property owner was effective under the policy's liability conditions, which allowed notice to be given 'by or for' the insured.

Alternatively, the court found the plaintiffs were entitled to relief from forfeiture under s. 129 of the Insurance Act, as the failure to give timely notice constituted imperfect compliance and the insurer suffered no prejudice.

The applicant was found outside his truck after it struck three parked vehicles.

He suffered a severe stroke and later died.

His estate sought statutory accident benefits, arguing the stroke was caused by the collision or a panic-induced spike in blood pressure resulting from the collision.

The insurer argued the stroke occurred spontaneously prior to the collisions.

The arbitrator found that the applicant's panic reaction to the first impact caused a precipitous rise in blood pressure, which, combined with his susceptibility to stroke and possible head trauma, caused the stroke.

Therefore, the impairments were sustained as a result of an 'accident' under the Schedule.

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

The insurer claimed it terminated the benefits and sent a notice of assessment, but the applicant, who had limited English skills, denied receiving it.

The insurer raised a preliminary issue that the applicant's arbitration request was barred by the two-year limitation period under s. 281(5) of the Insurance Act.

The arbitrator found that the insurer failed to prove it had delivered a clear and unequivocal notice of termination to the applicant.

As a result, the limitation period had not begun to run, and the applicant was not precluded from proceeding to arbitration.

The applicant was injured in a motor vehicle accident and received income replacement benefits from the insurer.

The insurer terminated and later reinstated benefits, paying a lump sum for the outstanding period.

The applicant sought interest on the late payment, arguing the insurer had sufficient information to pay earlier.

The arbitrator found the insurer had the necessary information by April 21, 1998, and the benefits were overdue from that date.

The insurer was ordered to pay interest at 2 per cent per month compounded from April 21, 1998, to the date of payment, along with the applicant's arbitration expenses.

The parties appealed an arbitration decision regarding the calculation of loss of earning capacity benefits (LECBs) and the insurer's obligation to continue paying income replacement benefits (IRBs) pending the resolution of the LECB dispute.

The Director's Delegate held that the 1995 amendments to the Statutory Accident Benefits Schedule, which removed the requirement to pay IRBs pending an LECB dispute, applied to the insured's ongoing claim and did not interfere with vested rights.

The Delegate upheld the arbitrator's calculation of pre-accident earning capacity, which considered a post-accident recall notice, and the calculation of residual earning capacity, which considered the insured's vocational preferences.

The insurer's appeal was allowed in part, and the insured's appeal was dismissed.

The applicant was injured in a snowmobile accident and received income replacement benefits (IRBs) for 104 weeks.

The insurer then terminated IRBs and offered a 'nil' loss of earning capacity (LEC) benefit.

The applicant disputed the LEC benefit amount and claimed entitlement to ongoing IRBs pending the dispute's resolution.

The arbitrator held that the pre-1995 version of the Statutory Accident Benefits Schedule applied, entitling the applicant to ongoing IRBs pending resolution.

The arbitrator determined the applicant's pre-accident earning capacity based on his intermittent employment history and his residual earning capacity based on an electronics assembler position, resulting in a weekly LEC benefit of $153.41.

The insurer was ordered to pay the ongoing IRBs, the LEC benefit, and the applicant's arbitration expenses.

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

A dispute arose over the calculation of his residual earning capacity for the purpose of determining his loss of earning capacity benefit.

The applicant argued that his residual earning capacity should be calculated using the formula in section 81 of the Statutory Accident Benefits Schedule, taking into account his true marginal tax rate due to his receipt of taxable long-term disability and Canada Pension Plan benefits.

The arbitrator held that the insurer was entitled to use the table prescribed by section 82 of the Schedule, which does not incorporate an insured's marginal income tax rate, and that the calculation of net weekly income does not require taking into account income tax payable on other sources of income.