Vadim Malyshev

The appellant Fund appealed an Arbitrator's preliminary decision finding that the respondent was involved in an 'accident' as defined in the Statutory Accident Benefits Schedule.

The respondent was injured after falling to the ground when a taxi van she was standing next to suddenly drove off.

The Fund argued the Arbitrator misapprehended the evidence, misapplied the definition of accident, and committed procedural errors.

The Director's Delegate dismissed the appeal, holding that the Arbitrator's findings of fact were supported by the evidence and that there was no palpable and overriding error, denial of a fair hearing, or reasonable apprehension of bias.

The applicant sought statutory accident benefits after allegedly being struck by a taxi van outside a banquet hall.

The insurer denied the claim, arguing the applicant failed to prove the incident occurred, pointing to the lack of a police report, inconsistencies in medical records, and delayed notice.

The arbitrator found the applicant and her witnesses credible, concluding she was knocked to the ground by the van and sustained an impairment.

The arbitrator also rejected the insurer's defence regarding late notice, finding the applicant had a reasonable explanation for the delay as she did not initially realize the incident qualified as a motor vehicle accident.

The applicant sought income replacement benefits, non-earner benefits, and medical expenses following a motor vehicle accident.

The arbitrator found that the applicant fabricated his pre-accident employment and was therefore not entitled to income replacement benefits.

The claim for non-earner benefits was dismissed as the applicant failed to prove a complete inability to carry on a normal life.

The arbitrator also held that the applicant's failure to attend a Designated Assessment Centre (DAC) barred him from recovering medical expenses incurred after the scheduled assessment date, but he was entitled to reasonable and necessary expenses incurred prior to that date.