6 total
Physiatry assessment approved but payable only after applicant cured non-compliance with information requests; special award denied.
The applicant sought entitlement to a physiatry assessment, a special award, and interest under the Statutory Accident Benefits Schedule following a motor vehicle accident.
The respondent insurer denied the assessment based on its own section 44 physiatry assessment and the applicant's failure to provide requested medical records.
The Tribunal found the physiatry assessment was reasonable and necessary based on the medical evidence, but held the insurer was not liable to pay until the applicant cured her section 33 non-compliance by providing the requested records.
The claim for a special award was dismissed as the insurer's denial was based on a rational assessment of the available information and did not constitute unreasonable conduct.
Arbitration application dismissed with costs after applicant failed to attend hearing and counsel was removed.
The applicant sought statutory accident benefits following a motor vehicle accident.
At the scheduled arbitration hearing, the applicant failed to attend.
The applicant's legal representative brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, which was granted.
The insurer brought an oral motion to dismiss the application for arbitration due to the applicant's non-attendance.
The arbitrator dismissed the application and awarded costs of $6,221.42 to the insurer, noting the applicant's failure to attend insurer's examinations, failure to provide income documentation, and failure to attend the hearing.
Insurer awarded $19,488.18 in expenses after successfully defending all accident benefit claims at arbitration.
Following an arbitration where the insurer successfully defended all claims for accident benefits, the insurer sought its expenses.
The arbitrator found the insurer was completely successful and that the applicant had rejected a reasonable settlement offer and failed to comply with undertakings.
The arbitrator assessed the insurer's expenses, allowing most fees and disbursements but excluding the cost of a court reporter, and ordered the applicant to pay $19,488.18 in expenses.
Accident benefits claims dismissed due to unsigned treatment plans and failure to escape Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought payment for three treatment plans.
The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The arbitrator dismissed the claims on two grounds.
First, the treatment plans were not signed by the applicant or a regulated health professional, as strictly required by section 38(3) of the Statutory Accident Benefits Schedule.
Second, the applicant failed to provide compelling medical evidence that her injuries, including her ongoing chronic pain, fell outside the MIG.
Applications for arbitration dismissed and expenses awarded after applicants failed to attend pre-hearing.
The applicants failed to attend a scheduled pre-hearing regarding their claims for statutory accident benefits.
Their counsel brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, which was granted.
The arbitrator dismissed the applications for arbitration as frivolous, vexatious, or commenced in bad faith due to the applicants' failure to participate, and ordered the applicants to pay $1,000 in expenses to the insurer.
Arbitration application dismissed and costs awarded after applicant failed to participate in proceedings.
The applicant was injured in an automobile accident and sought statutory accident benefits.
After his legal counsel lost contact with him and was removed from the record, the applicant failed to attend a scheduled pre-hearing discussion and a subsequent preliminary issue hearing.
The insurer requested that the application be dismissed with costs.
The arbitrator dismissed the application without a hearing under Rule 68 of the Dispute Resolution Practice Code, finding it frivolous, vexatious, or commenced in bad faith due to the applicant's failure to participate.
The insurer was awarded $250 in throw away costs for having to prepare for the proceedings.
