Asfaw Seife is a arbitrator at the Ontario Financial Services Commission - Dispute Resolution Services with 58 decisions on record from 1994 to 2001. Key areas include statutory accident benefits schedule matters (sabs), other tribunals, administrative law.

What tribunal does Asfaw Seife sit on?

Asfaw Seife sits on the Ontario Financial Services Commission - Dispute Resolution Services.

What areas of law does Asfaw Seife decide?

Asfaw Seife's most common areas include Statutory Accident Benefits Schedule matters (SABS) (58 decisions), Other Tribunals (5 decisions), Administrative Law (1 decisions). Asfaw Seife has handled 58 decisions across 3 areas.

How many decisions has Asfaw Seife made?

Asfaw Seife has 58 decisions on record from 1994 to 2001.

Who frequently appears before Asfaw Seife?

Representatives who frequently appear before Asfaw Seife include J. Claude Blouin, Joan Takahashi, Doug Wallace.

Asfaw Seife — Arbitrator

David Pinhasov v. Guarantee Company of North America, 2001 ONFSCDRS 154

Ongoing income replacement benefits awarded for chronic pain; special award denied as termination was not unreasonable.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on a disability assessment.

The applicant sought ongoing benefits, arguing that accident-related headaches, neck, and back pain prevented him from working full-time as a travel agent.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment due to chronic pain from soft-tissue injuries and aggravated pre-existing conditions.

The arbitrator ordered the insurer to pay ongoing income replacement benefits but denied the applicant's claim for a special award, finding the insurer's termination of benefits was not unreasonable.

OFSCDRSOct 25, 2001

Fenech v. State Farm Mutual Automobile Insurance Company, 2001 ONFSCDRS 124

Claim for cost of medical assessments dismissed as they were not reasonably incurred under the Schedule.

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

The insurer terminated medical benefits based on an independent medical examination.

Over two years later, the applicant's lawyer arranged for functional abilities and orthopaedic assessments without the insurer's approval.

The insurer refused to pay the $2,568 cost of these assessments.

The arbitrator found that the applicant failed to prove the assessments were reasonably incurred for the purposes of the Schedule, noting the lack of medical evidence supporting the need for the assessments and the long period of inactivity on the file.

The claim for the cost of examinations and a special award was dismissed.

OFSCDRSAug 29, 2001

Sonia Pinhasov v. Guarantee Company of North America, 2001 ONFSCDRS 123

Ongoing income replacement benefits awarded where accident caused disabling psychological impairments and chronic pain.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them.

She applied for arbitration seeking ongoing IRBs, housekeeping expenses, and a special award.

The arbitrator found that the applicant suffered from physical and psychological impairments, including post-traumatic stress disorder and chronic pain, caused by the accident.

The arbitrator concluded that she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a fabric cutter and awarded ongoing IRBs.

Housekeeping expenses were partially awarded for the initial period following the accident.

The claim for a special award was dismissed, and the issue of repayment was deferred.

OFSCDRSAug 24, 2001

Dalbir Singh Dhami v. State Farm Mutual Automobile Insurance Company, 2000 ONFSCDRS 208

Arbitration application dismissed for non-attendance; applicant ordered to pay insurer's assessment fee and expenses.

The applicant sought income replacement benefits following a motor vehicle accident.

The applicant and his representative failed to attend the arbitration hearing and failed to produce required documents.

The arbitrator proceeded in their absence and dismissed the application for lack of evidence.

Finding that the applicant's conduct constituted an abuse of process, the arbitrator ordered the applicant to pay the insurer's $3,000 assessment fee and $500 in arbitration expenses.

OFSCDRSNov 21, 2000

Brent Ford v. Wawanesa Mutual Insurance Company, 2000 ONFSCDRS 191

Applicant awarded full arbitration expenses after largely succeeding in his claim for statutory accident benefits.

The applicant sought an award of his arbitration expenses following a successful claim for statutory accident benefits.

The insurer argued the applicant was only entitled to half his expenses due to partial success.

The arbitrator found the applicant was largely successful, presented his case efficiently, and raised novel and complex issues.

Applying the criteria in s. 12(2) of Ontario Regulation 664, the arbitrator awarded the applicant all of his reasonably incurred arbitration expenses.

OFSCDRSOct 20, 2000

Suhul Michael Tedla v. Royal & SunAlliance Insurance Company of Canada, 2000 ONFSCDRS 175

Arbitration application deemed withdrawn for abandonment; applicant ordered to pay insurer's assessment fee and expenses.

The applicant failed to attend his scheduled arbitration hearing for statutory accident benefits, and his counsel was granted leave to withdraw.

The arbitrator found that the applicant had abandoned the proceeding and that his failure to pursue the application or provide notice constituted an abuse of process.

The application was deemed withdrawn, and the applicant was ordered to pay the insurer's assessment fee of $3,000 and arbitration expenses of $750.

OFSCDRSSep 26, 2000

Mouyad Darwish v. Liberty Mutual Insurance Company, 2000 ONFSCDRS 68

Insurer improperly terminated income replacement benefits; applicant's psychotic disorder found to be accident-related.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them, alleging failure to cooperate with a Residual Earning Capacity Designated Assessment Centre (REC DAC).

The applicant applied for arbitration, seeking ongoing IRBs and attendant care benefits.

The arbitrator found that the REC DAC did not report a failure to cooperate, meaning the insurer improperly stopped the IRBs.

On the merits, the arbitrator preferred the evidence of the applicant's medical experts, finding that the applicant suffered from a psychotic disorder and post-concussion syndrome caused by the accident, rendering him substantially unable to perform his pre-accident employment.

The insurer's allegations of malingering were rejected.

However, the claim for attendant care benefits was dismissed due to insufficient evidence of need, particularly given surveillance showing the applicant driving and taking public transit independently.

OFSCDRSApr 7, 2000

John Reith v. Halifax Insurance Company, 2000 ONFSCDRS 67

Insurer ordered to pay chiropractic expenses after arbitrator finds treatments reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic treatments.

The insurer refused to pay, relying on a designated assessment centre report which concluded the treatments were not reasonable and necessary.

The arbitrator found that the applicant had sustained a cervical fracture and that the chiropractic treatments provided appreciable subjective and objective improvement.

The arbitrator rejected the insurer's medical evidence, which relied on an unfounded diagnosis of depression, and ordered the insurer to pay the incurred chiropractic expenses.

OFSCDRSApr 6, 2000

Wayne Dutton v. Liberty Mutual Insurance Company, 2000 ONFSCDRS 35

Insurer permitted to add unmediated repayment issue to arbitration provided it withdraws related court action.

The insured applied for arbitration after the insurer terminated his income replacement benefits (IRBs).

The insurer subsequently commenced a court action seeking repayment of the IRBs, alleging wilful misrepresentation or fraud.

The insurer then brought a motion to add the issue of repayment to the ongoing arbitration.

The insured objected, arguing the issue was not mediated and was the subject of an existing court action.

The arbitrator granted the insurer's motion, finding that under the amended section 282(3) of the Insurance Act, the arbitrator has jurisdiction to determine all issues in dispute.

The arbitrator held that the repayment issue reasonably and consequentially flowed from the mediated issue of entitlement to IRBs, and permitted the insurer to add the issue provided it withdrew the related court action to avoid a multiplicity of proceedings.

OFSCDRSFeb 10, 2000

Ward v. Dominion of Canada General Insurance Company, 1999 ONFSCDRS 258

Applicants awarded arbitration expenses; interest on overdue benefits calculated from 30 days after accountant's report.

The Applicants sought their arbitration expenses and a determination of the date from which interest should be calculated on shortfall payments of income replacement benefits following a previous arbitration decision.

The Arbitrator awarded the Applicants their arbitration expenses, finding that their claims were not frivolous or vexatious and they did not unreasonably prolong the proceedings.

Regarding interest, the Arbitrator determined that the payments became overdue on June 14, 1997, 30 days after the insurer received an accountant's report calculating the correct benefit amount, as it was impossible for the insurer to determine the correct amount prior to that date due to the Applicant's delay in providing financial information.

OFSCDRSDec 24, 1999

Brent Ford v. Wawanesa Mutual Insurance Company, 1999 ONFSCDRS 240

Arbitrator sets residual earning capacity to zero and orders indexation of pre-accident earning capacity.

The applicant was injured in a motor vehicle accident while riding his motorcycle and applied for statutory accident benefits.

Disputes arose regarding the calculation of his income replacement benefits (IRBs), the indexation of his pre-accident earning capacity (PEC) for loss of earning capacity benefits (LECBs), his residual earning capacity (REC), and his entitlement to a special award.

The arbitrator determined that the applicant's gross annual income should be calculated based on the 52 weeks prior to the accident, including accrued vacation pay.

The arbitrator also held that the applicant's PEC must be indexed before calculating LECBs.

Furthermore, the arbitrator rejected the Designated Assessment Centre's (DAC) finding that the applicant could work as a part-time sales representative, concluding that such employment did not exist in the Thunder Bay area, and deemed his REC to be zero.

The claim for a special award was dismissed as the insurer's conduct was not found to be unreasonable.

OFSCDRSDec 10, 1999

Maria Marton-Lamberti v. General Accident Assurance Co. of Canada, 1999 ONFSCDRS 230

Limitation period did not commence because insurer failed to provide clear reasons for refusing benefits.

The applicant was injured in a motor vehicle accident and received weekly income benefits for 156 weeks.

The insurer stopped payments and sent a letter regarding an alleged overpayment, but did not explicitly state reasons for refusing further benefits.

The insurer raised a preliminary issue that the application for arbitration was time-barred under the two-year limitation period.

The arbitrator found that the insurer's letter did not constitute proper written notice of refusal because it lacked clear reasons for the refusal.

Therefore, the limitation period had not commenced, and the applicant was not precluded from proceeding to arbitration.

OFSCDRSNov 29, 1999

Lilianne P. Stringer v. Zurich Insurance Company, 1999 ONFSCDRS 144

Arbitration application dismissed as mediation was not commenced within the two-year limitation period.

The applicant was injured in a motor vehicle accident and received statutory accident benefits for nearly five years.

The insurer terminated her benefits and provided clear and unequivocal notice of its refusal to pay further benefits.

The applicant retained counsel but an Application for Mediation was not filed until almost three years after the termination.

The arbitrator held that the applicant was precluded from proceeding to arbitration because she failed to commence mediation proceedings within the two-year limitation period prescribed by the Insurance Act and the Statutory Accident Benefits Schedule.

The application for arbitration was dismissed.

OFSCDRSJul 22, 1999

Beryl Ward and Douglas Ward v. Dominion of Canada General Insurance Company, 1999 ONFSCDRS 121

Claims for ongoing post-156 week statutory accident benefits dismissed for both applicants.

The applicants, a husband and wife, were injured in a rear-end motor vehicle collision and received weekly statutory accident benefits for three years.

The insurer terminated benefits on the basis that neither applicant met the stricter post-156 week disability tests.

The arbitrator found that the wife's pre-existing degenerative disc disease was aggravated by the accident, causing a herniation, but that she was not continuously prevented from engaging in substantially all of her normal activities, as evidenced by surveillance and her continued volunteer work.

The husband, who had significant pre-existing back problems, claimed ongoing disability from chronic pain syndrome.

The arbitrator dismissed his claim for ongoing benefits, noting he had returned to work briefly, played golf frequently, and his psychological evidence was inconsistent.

The arbitrator did order the insurer to pay a shortfall in the husband's pre-termination benefits based on an accountant's calculation, but denied a special award.

OFSCDRSJun 25, 1999

Barbara Miller v. Allstate Insurance Company of Canada, 1999 ONFSCDRS 72

Arbitration permitted to proceed on the condition that the insured withdraws concurrent court action.

The insured applied for statutory accident benefits and subsequently referred a dispute over a psycho-vocational assessment to arbitration.

Shortly after, the insured commenced a civil action in court claiming medical and rehabilitation benefits, which encompassed the same assessment expense.

The insurer brought a preliminary motion to dismiss the arbitration, arguing that the insured had elected to proceed in court and that the concurrent proceedings constituted an abuse of process.

The arbitrator found that the issues in both forums were the same, but permitted the insured to proceed with the arbitration on the condition that she withdraw the related court action or amend her statement of claim to exclude the disputed expense.

The insurer was awarded $250 in expenses for the motion.

OFSCDRSApr 29, 1999

Minassian v. Halifax Insurance Company, 1999 ONFSCDRS 54

Application for ongoing accident benefits dismissed due to lack of credible evidence of substantial inability.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them based on a DAC assessment.

The applicant sought ongoing IRBs, supplementary medical and housekeeping expenses, and the cost of a medical report.

The insurer sought repayment of an overpaid benefit.

The arbitrator found the applicant was not a credible witness due to inconsistent pain behaviour, discrepancies between his testimony and medical records, and surveillance video showing him working.

The arbitrator concluded the applicant did not suffer a substantial inability to perform his essential tasks as an auto mechanic and dismissed the claims for ongoing IRBs, physiotherapy, and housekeeping expenses.

The claim for the medical report cost was also dismissed as it was obtained for litigation.

The insurer's claim for repayment was dismissed for failing to provide the required notice.

OFSCDRSMar 31, 1999

Hai T. Nguyen v. Kingsway General Insurance Company, 1999 ONFSCDRS 15

Application for accident benefits dismissed; arbitrator found no collision occurred and awarded costs against applicant.

The applicant sought statutory accident benefits, claiming she was injured when her vehicle was rear-ended.

The insurer denied the claim on the basis that no accident occurred.

At arbitration, the drivers of the vehicles behind the applicant testified that their vehicles collided but did not strike the applicant's vehicle.

The arbitrator found the applicant's testimony inconsistent and unreliable, preferring the evidence of the other drivers.

The arbitrator concluded that the applicant's vehicle was not rear-ended and she did not sustain an impairment.

The application was dismissed, and the applicant was ordered to pay the insurer's arbitration expenses due to the vexatious nature of the claim.

OFSCDRSJan 21, 1999

Teresa Commisso v. Canadian General Insurance Group, 1998 ONFSCDRS 66

Insurer ordered to pay income replacement benefits as applicant's chronic pain caused substantial inability to work.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated her income replacement and housekeeping benefits.

The applicant applied for arbitration, claiming ongoing entitlement to income replacement benefits, loss of earning capacity benefits, physiotherapy, and housekeeping expenses.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment due to chronic pain, despite a lack of objective musculoskeletal findings, and ordered the insurer to pay income replacement benefits and make an offer for loss of earning capacity benefits.

The claims for physiotherapy and housekeeping expenses were dismissed due to a lack of supporting evidence.

OFSCDRSOct 30, 1998

Joan Privett v. Allstate Insurance Company of Canada, 1998 ONFSCDRS 50

Application for accident benefits dismissed due to late notice and lack of credible evidence of disability.

The applicant was involved in a motor vehicle accident and applied for statutory accident benefits, including caregiver benefits and housekeeping expenses, approximately ten months later.

The insurer denied the claim on the basis that the applicant failed to provide notice of her injuries within 30 days as required by section 59(1) of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant's evidence regarding her reporting of injuries and her functional disability lacked credibility.

The arbitrator concluded that the applicant failed to comply with the notice requirements without a reasonable excuse and did not suffer a substantial inability to engage in her caregiver activities.

The application for benefits, a special award, and arbitration expenses was dismissed.

OFSCDRSOct 9, 1998

Sami Bouassali v. Zurich Insurance Company, 1998 ONFSCDRS 27

Limitation period for accident benefits arbitration is not triggered without a written notice of refusal.

The Applicant sought arbitration for statutory accident benefits following a motor vehicle accident.

The Insurer raised a preliminary issue, arguing the application was time-barred because it was filed more than two years after a verbal refusal to pay benefits, and that the issue of ongoing entitlement had not been mediated.

The Arbitrator held that the limitation period under the Insurance Act and the Statutory Accident Benefits Schedule is only triggered by a clear, written notice of refusal, which the Insurer failed to provide.

The Arbitrator also exercised discretion to allow the arbitration to proceed despite the mediation occurring after the application was filed.

The preliminary motion was dismissed, and the Applicant was awarded expenses.

OFSCDRSAug 28, 1998

David Pinhasov v. Guarantee Company of North America, 2001 ONFSCDRS 154

Fenech v. State Farm Mutual Automobile Insurance Company, 2001 ONFSCDRS 124

Sonia Pinhasov v. Guarantee Company of North America, 2001 ONFSCDRS 123

Dalbir Singh Dhami v. State Farm Mutual Automobile Insurance Company, 2000 ONFSCDRS 208

Brent Ford v. Wawanesa Mutual Insurance Company, 2000 ONFSCDRS 191

Suhul Michael Tedla v. Royal & SunAlliance Insurance Company of Canada, 2000 ONFSCDRS 175

Mouyad Darwish v. Liberty Mutual Insurance Company, 2000 ONFSCDRS 68

John Reith v. Halifax Insurance Company, 2000 ONFSCDRS 67

Wayne Dutton v. Liberty Mutual Insurance Company, 2000 ONFSCDRS 35

Ward v. Dominion of Canada General Insurance Company, 1999 ONFSCDRS 258

Brent Ford v. Wawanesa Mutual Insurance Company, 1999 ONFSCDRS 240

Maria Marton-Lamberti v. General Accident Assurance Co. of Canada, 1999 ONFSCDRS 230

Lilianne P. Stringer v. Zurich Insurance Company, 1999 ONFSCDRS 144

Beryl Ward and Douglas Ward v. Dominion of Canada General Insurance Company, 1999 ONFSCDRS 121

Barbara Miller v. Allstate Insurance Company of Canada, 1999 ONFSCDRS 72

Minassian v. Halifax Insurance Company, 1999 ONFSCDRS 54

Hai T. Nguyen v. Kingsway General Insurance Company, 1999 ONFSCDRS 15

Teresa Commisso v. Canadian General Insurance Group, 1998 ONFSCDRS 66

Joan Privett v. Allstate Insurance Company of Canada, 1998 ONFSCDRS 50

Sami Bouassali v. Zurich Insurance Company, 1998 ONFSCDRS 27

for Allstate

for Allstate Insurance Company of Canada

for Dominion of Canada General Insurance Company

for General Accident Assurance Co. of Canada

for Guarantee Company of North America

for Halifax Insurance Company

for Kingsway General Insurance Company

for Liberty Mutual Insurance Company

for Mr. and Mrs. Ward

for Mr. Darwish

for Mr. Dutton

for Mr. Ford

for Mr. Minassian

for Mr. Pinhasov

for Mr. Reith

for Mrs. Marton-Lamberti

for Mrs. Miller

for Mrs. Stringer

for Mr. Tedla

for Ms. Fenech

for Ms. Nguyen

for Ms. Pinhasov

for Royal & SunAlliance Insurance Company of Canada

for State Farm Mutual Automobile Insurance Company

for the Applicant

for the Insurer

for Wawanesa Mutual Insurance Company

for Zurich Insurance Company

Decision types