Vance H. Cooper

The insured was seriously injured in a motorcycle accident in Florida.

Her travel insurer paid her medical expenses and sought to assert a subrogated claim against the insurer of the at-fault driver.

The application judge held that the travel insurer had no right of subrogation because its policy had to conform to the Ontario Insurance Act, which bars subrogation for health care expenses.

On appeal, the Court of Appeal affirmed the decision, holding that Ontario contract law, not Florida tort law, governed the subrogation right.

The Court also applied the Fraser River principled exception to privity of contract, allowing the at-fault driver's insurer to benefit from the statutory waiver of subrogation.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them after the 156-week mark.

The applicant sought ongoing benefits under subsection 12(5)(b) of the Statutory Accident Benefits Schedule, arguing she was continuously prevented from engaging in suitable employment.

The arbitrator found that the applicant lacked the physical capacity to return to her former physically demanding jobs and lacked the skills for sedentary office work without further retraining.

The arbitrator ordered ongoing weekly income benefits.

Additionally, the arbitrator awarded a $10,000 special award under section 282(10) of the Insurance Act because the insurer unreasonably terminated benefits without proper notice or justification.

The Applicant claimed statutory accident benefits following two alleged motor vehicle accidents.

In a previous decision, the arbitrator found the Applicant was not involved in the second accident and had made a serious misrepresentation to the Insurer.

The Insurer sought repayment of benefits paid after the second accident and a further assessment for the first accident claim.

The arbitrator dismissed the request for a further assessment, finding the first accident claim was not frivolous or vexatious simply because it was dismissed for failure to pay an initial assessment.

However, the arbitrator ordered the Applicant to repay $122,151.21 in benefits relating to the second accident, finding she materially contributed to the overpayment through her misrepresentation.

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

In a prior preliminary decision, the arbitrator found the applicant misrepresented her involvement in a second accident and ordered her to pay a $1,000 assessment before the hearing could proceed.

The applicant failed to pay the assessment and did not appear at the scheduled hearing.

Consequently, the arbitrator dismissed her application for arbitration.

The insurer's claim for repayment of benefits was adjourned to a later date to ensure fairness, as the applicant may have mistakenly believed no hearing would proceed until the assessment was paid.

The arbitrator also confirmed jurisdiction to hear the insurer's repayment claim under the amended section 282(3) of the Insurance Act.

The applicant sought statutory accident benefits following two alleged motor vehicle accidents.

The insurer raised preliminary issues, arguing the first accident claim was settled, time-barred, and precluded by a civil proceeding.

The arbitrator dismissed these arguments, finding no final settlement, that the limitation period had not expired due to unclear termination notice, and that the civil action did not bar the arbitration.

Regarding the second accident, the arbitrator found the applicant was not an occupant of the vehicle and had misrepresented her involvement.

The insurer's request for repayment was reserved, but the applicant was ordered to pay a $1,000 assessment for an abuse of process regarding the second accident claim.

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

The insurer terminated the weekly income benefits, arguing the applicant was no longer substantially unable to perform the essential tasks of his pre-accident employment as a videographer and newspaper worker.

The applicant applied for arbitration to reinstate the benefits and determine the proper quantum.

The arbitrator found that the applicant failed to prove a substantial inability to perform his essential tasks beyond the termination date, dismissing the claim for ongoing benefits.

However, the arbitrator determined the proper quantum of the weekly benefit was the maximum $600 per week, and therefore dismissed the insurer's claim for repayment of alleged overpayments.