6 total
Claims for income replacement and physiotherapy dismissed due to credibility issues; assessment and travel expenses awarded.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, physiotherapy expenses, travel expenses, and the cost of a medical assessment report.
The arbitrator dismissed the claims for income replacement benefits and physiotherapy, finding the applicant's evidence lacked credibility and noting inconsistencies in his testimony regarding his job duties and post-accident conduct.
The arbitrator awarded $52 for travel expenses and $963 for the cost of a physiatry report, finding those expenses reasonable and necessary.
The claim for a special award was dismissed as the insurer's cautious approach was justified given the credibility concerns.
Applicant found to be self-employed; ongoing IRBs denied and repayment ordered for overpayment.
The applicant was injured in a motor vehicle accident and claimed ongoing income replacement benefits (IRBs) and medical rehabilitation benefits.
The arbitrator determined that the applicant was an independent contractor, not an employee, and calculated her pre-accident income accordingly, resulting in a lower IRB rate.
The arbitrator found insufficient medical evidence to support a substantial inability to perform the essential tasks of her employment beyond the insurer's termination date.
Consequently, the applicant was ordered to repay the insurer for the overpayment of IRBs.
However, the insurer was ordered to pay for outstanding physiotherapy treatments, which were found to be reasonable and necessary.
Claims for accident benefits dismissed as applicants failed to prove the motor vehicle accident occurred.
The applicants claimed statutory accident benefits following an alleged motor vehicle accident with a taxi.
The insurer denied the claims, arguing the accident never occurred, and sought repayment of benefits already paid.
The arbitrator found the applicants' evidence regarding the events leading up to the accident and the accident itself to be implausible and riddled with inconsistencies.
Consequently, the applicants failed to prove on a balance of probabilities that the accident occurred, and their claims for benefits were dismissed.
However, the insurer's claim for repayment was also dismissed, as it failed to provide clear and convincing evidence of wilful misrepresentation or fraud.
Accident benefits claim dismissed and $3,000 penalty imposed after arbitrator found applicant was not an occupant.
The applicant sought statutory accident benefits, claiming he was an occupant of an insured vehicle involved in a collision.
The insurer denied benefits on the basis that the applicant was not an occupant of the vehicle at the time of the accident.
The arbitrator found the applicant's evidence to be inconsistent and unreliable, and preferred the evidence of the third-party driver and the insurer's accident reconstruction experts.
The arbitrator concluded that the applicant was not an occupant of the vehicle and therefore not an insured person entitled to benefits.
The application was dismissed, and the applicant was ordered to pay $3,000 to the insurer for commencing a frivolous and vexatious arbitration.
Application for statutory accident benefits dismissed due to applicant's failure to attend the arbitration hearing.
The applicant applied for statutory accident benefits following an alleged motor vehicle accident.
The insurer denied the claim on the basis that the applicant was not a passenger in a motor vehicle involved in an accident.
The applicant failed to attend the arbitration hearing despite receiving reasonable notice.
The arbitrator proceeded in the applicant's absence pursuant to the Statutory Powers Procedure Act and the Dispute Resolution Practice Code.
As the applicant provided no evidence to support his claim, the application was dismissed.
Arbitration for weekly income benefits dismissed as statute-barred by the two-year limitation period.
The applicant was injured in motor vehicle accidents in 1991 and received weekly income benefits until the insurer terminated them.
The insurer raised a preliminary issue that the applicant's request for arbitration was barred by the two-year limitation period under section 281(5) of the Insurance Act.
The arbitrator found that the insurer provided clear and unequivocal notice of termination on November 22, 1993, after an independent medical examination.
The arbitrator rejected the applicant's arguments that the insurer waived the limitation period through ongoing negotiations, that a rolling limitation period applied, or that the arbitrator had jurisdiction to extend the statutory limitation period.
The application for arbitration was dismissed as statute-barred, but the applicant was awarded expenses.
