Denise Ashby is a arbitrator at the Ontario Financial Services Commission - Dispute Resolution Services with 88 decisions on record from 2004 to 2012. Key areas include statutory accident benefits schedule matters (sabs), other tribunals, administrative law.

What tribunal does Denise Ashby sit on?

Denise Ashby sits on the Ontario Financial Services Commission - Dispute Resolution Services.

What areas of law does Denise Ashby decide?

Denise Ashby's most common areas include Statutory Accident Benefits Schedule matters (SABS) (88 decisions), Other Tribunals (14 decisions), Administrative Law (3 decisions). Denise Ashby has handled 88 decisions across 3 areas.

How many decisions has Denise Ashby made?

Denise Ashby has 88 decisions on record from 2004 to 2012.

Who frequently appears before Denise Ashby?

Representatives who frequently appear before Denise Ashby include James M. Brown, Pradeep B. Pachai, Marlett Dobson.

Denise Ashby — Arbitrator

Michael Vieira v. Aviva Canada Inc., 2012 ONFSCDRS 60

Insurer awarded $10,000 in expenses after successfully defending against claims for statutory accident benefits.

The insurer sought its expenses following a successful defence of the applicant's claims for statutory accident benefits.

The arbitrator found that the insurer was entitled to its expenses because it was completely successful, there were no novel issues, and the applicant's conduct hindered and prolonged the proceedings.

The insurer claimed $23,976.78, but the arbitrator fixed the expenses at $10,000, noting that the matter was not complex and the insurer was unsuccessful in a previous motion to dismiss.

OFSCDRSApr 16, 2012

Hoang v. Personal Insurance Company of Canada, 2012 ONFSCDRS 53

Insurer ordered to pay $50,525.60 in arbitration expenses following successful statutory accident benefits claim.

The applicant sought expenses following a successful arbitration for statutory accident benefits.

The applicant claimed $75,719.35 in expenses, including legal fees and disbursements.

The insurer argued that the attendance of two senior counsel was unnecessary and disputed certain disbursements.

The arbitrator agreed that two senior counsel were not required for the hearing but allowed some time for the second counsel's pre-hearing work.

The arbitrator also disallowed disbursements for medical illustrations and a video, and reduced an expert's fee to the regulatory maximum.

The insurer was ordered to pay the applicant $50,525.60 in expenses, inclusive of HST.

OFSCDRSMar 23, 2012

Jaswant Kaur v. Personal Insurance Company of Canada, 2012 ONFSCDRS 50

Caregiver benefits denied; visiting grandparent on temporary visa was not 'residing with' the grandchild.

The applicant, who was visiting Canada from India on a visitor's visa, was injured in a motor vehicle accident and claimed caregiver benefits for looking after her grandson.

The insurer suspended her benefits after she failed to attend a rescheduled insurer's examination because she had returned to India.

The arbitrator found that the insurer properly suspended the benefits under section 37(7) of the Schedule.

Furthermore, the arbitrator held that the applicant was not entitled to caregiver benefits because her temporary visitor status meant she was not 'residing with' her grandson, she was not the primary caregiver, and she failed to establish a substantial inability to engage in pre-accident caregiving activities.

Claims for a special award and interest were consequently dismissed.

OFSCDRSMar 20, 2012

Michael Vieira v. Aviva Canada Inc., 2012 ONFSCDRS 29

Paralegal firm removed from record due to relationship breakdown; further adjournment of expense hearing denied.

The applicant's paralegal firm brought a motion to be removed as the representative of record due to a breakdown in the representative and client relationship.

The arbitrator granted the motion, finding that the applicant had lost confidence in the firm and terminated their retainer.

The arbitrator also denied a further adjournment of the pending expense hearing, noting that the applicant had failed to participate or respond to the insurer's submissions despite receiving notice.

OFSCDRSMar 9, 2012

Marcia Henry v. State Farm Mutual Automobile Insurance Company, 2012 ONFSCDRS 21

Insurer ordered to pay post-104 week income replacement benefits and a $23,000 special award.

The applicant, an emergency nurse, was injured in a motor vehicle accident and sought post-104 week income replacement benefits.

The insurer terminated benefits, arguing she was not substantially disabled.

The arbitrator found that the applicant suffered a complete inability to engage in suitable employment due to her ongoing physical restrictions and the unlikelihood of being hired for sedentary work given her age and disability.

The arbitrator also held that a lump-sum settlement from a collateral carrier could not be deducted from the income replacement benefits.

A special award of $23,000 was granted because the insurer unreasonably withheld benefits by failing to meaningfully adjust the claim after the 104-week mark.

OFSCDRSMar 1, 2012

Michael Vieira v. Aviva Canada Inc., 2011 ONFSCDRS 110

Claims for statutory accident benefits dismissed due to unreliable testimony and significant pre-existing medical history.

The applicant was injured in a motor vehicle accident and claimed statutory accident benefits for caregiving, attendant care, housekeeping, and a psychological assessment.

The insurer denied the claims.

The arbitrator found the applicant's testimony unreliable and preferred the clinical notes of his family physician, which showed a significant pre-accident history of kidney stones and narcotic drug dependence.

The arbitrator concluded the applicant was not substantially disabled from his pre-accident activities shortly after the accident and was not the primary caregiver of his children.

The claim for the psychological assessment was denied because the application form did not meet the statutory screening requirements and the assessment relied on inaccurate pre-accident history.

All claims, including a claim for a special award, were dismissed.

OFSCDRSDec 2, 2011

Qadeer Osmani v. Economical Mutual Insurance Company, 2011 ONFSCDRS 90

Insurer ordered to produce adjuster's file and policy manuals; applicant ordered to produce prior insurance and medical records.

The applicant sought statutory accident benefits following a motor vehicle accident, which the insurer denied on the basis that the accident was staged.

Both parties brought preliminary motions for the production of documents.

The arbitrator ordered the insurer to produce its complete adjuster's file and policy manuals, finding that the dominant purpose of an adjuster's file is the adjusting of the claim and is therefore producible, subject to specific claims of privilege.

The insurer was not required to produce legal opinions or reserves.

The applicant was ordered to produce his RBC insurance file, specific Ontario Works records, and clinical notes from one year prior to the accident.

OFSCDRSOct 14, 2011

Christopher Hoang (A Minor By His Litigation Guardian, San Trieu) v. Personal Insurance Company of Canada, 2011 ONFSCDRS 84

Insurer ordered to pay rehabilitation benefits and a $28,000 special award for unreasonably denying treatment.

The applicant, a minor who sustained a catastrophic brain injury in a motor vehicle accident, sought statutory accident benefits for private school tuition and rehabilitation support worker services.

The insurer denied the claims based on its own medical examinations.

The arbitrator found the insurer's denials unreasonable, preferring the evidence of the applicant's treating team that the services were necessary for his social reintegration and cognitive development.

The arbitrator awarded the claimed benefits, interest, and a $28,000 special award against the insurer for unreasonably withholding payments.

OFSCDRSSep 29, 2011

Jaswant Kaur v. Personal Insurance Company of Canada, 2011 ONFSCDRS 67

Applicant residing in India must attend hearing in person if insurer requires cross-examination.

The applicant, who resides in India, brought a motion to participate in her arbitration hearing by teleconference or video conference.

The insurer took no position on the format but reserved its right to cross-examine the applicant.

The arbitrator held that an electronic hearing would be inappropriate if cross-examination on documents was required, given the applicant's need for an interpreter and unfamiliarity with the process.

The arbitrator ordered that the applicant must attend in person if the insurer gives notice of its intent to cross-examine her by a specified date; otherwise, she may participate by teleconference.

OFSCDRSAug 12, 2011

Luis Almeida v. Lombard General Insurance Company of Canada, 2011 ONFSCDRS 51

Arbitration claim for accident benefits deemed withdrawn after applicant failed to participate or communicate.

The applicant was involved in a motor vehicle accident and applied for statutory accident benefits.

After a period of non-participation and failure to communicate with his counsel or the Commission, the insurer brought a motion to dismiss the claim without a hearing or deem it withdrawn.

The arbitrator found that while the applicant's conduct constituted bad faith, it did not occur at the commencement of the arbitration as required for a dismissal under Rule 68.

However, given the applicant's complete failure to participate, the arbitrator inferred that he had abandoned his claim and deemed it withdrawn pursuant to Rule 70 of the Dispute Resolution Practice Code.

OFSCDRSJun 16, 2011

Leon Francis Rocheleau v. Allstate Insurance Company of Canada, 2011 ONFSCDRS 49

Applicant denied arbitration expenses due to unexcused 2.5-year delay in requesting expense hearing.

The applicant sought expenses following a successful arbitration for statutory accident benefits.

The insurer argued the claim was barred by Rule 79.1 of the Dispute Resolution Practice Code, as the applicant waited 2.5 years to request an expense hearing instead of the required 30 days.

The arbitrator found the applicant's explanation for the delay uncompelling and declined to extend the time limit under Rule 81.

The applicant was denied his expenses of $29,008.12 due to the delay.

The arbitrator also declined to address an alleged error in the insurer's interest calculation, finding no authority to do so in an expense hearing.

OFSCDRSMay 30, 2011

Abdirizzak Hassan Ismail v. State Farm Mutual Automobile Insurance Company, 2011 ONFSCDRS 34

Application for arbitration withdrawn on consent of the parties.

OFSCDRSApr 1, 2011

Luis Almeida v. Lombard General Insurance Company of Canada, 2011 ONFSCDRS 33

Counsel removed from record due to loss of contact; motion to dismiss arbitration adjourned.

The applicant's counsel brought a motion to be removed from the record due to a breakdown in the solicitor-client relationship, as the applicant had left the country without providing contact information.

The arbitrator granted the motion.

The insurer brought a motion to dismiss the arbitration proceeding due to the applicant's non-attendance.

The arbitrator adjourned the motion to dismiss to allow the insurer to serve its motion record on the applicant at his last known address.

OFSCDRSApr 1, 2011

Rosa Benjamin v. Belair Insurance Company Inc., 2011 ONFSCDRS 24

Insurer ordered to pay applicant's arbitration expenses after partial success on statutory accident benefits claim.

Following an arbitration decision where the applicant was partially successful in claiming statutory accident benefits, both parties sought their expenses of the proceeding.

The arbitrator found that the applicant was entitled to her expenses because she was partially successful and reasonably proceeded to a hearing to preserve her claim for future medical benefits, despite the insurer's offer to settle.

The insurer was ordered to pay the applicant's expenses of the arbitration and the expense hearing, fixed at $8,764.14 plus HST.

OFSCDRSMar 8, 2011

Daniel Prete v. State Farm Mutual Automobile Insurance Company, 2011 ONFSCDRS 7

Motion for production of applicant's restricted Facebook photos denied due to remote relevance and privacy concerns.

In an arbitration for statutory accident benefits, the insurer brought a motion seeking production of photographs and videos posted to the applicant's restricted Facebook account.

The insurer argued the images were relevant to the applicant's claim for income replacement and housekeeping benefits.

The arbitrator dismissed the motion, finding that the insurer failed to establish a reasonable relationship between the images and the issues to be arbitrated.

The arbitrator held that the potential relevance of social media images was too remote when weighed against the procedural burden, sensitivity, and practicality of producing them in an administrative tribunal context.

OFSCDRSJan 13, 2011

Fong-Wai Lawrence Huang v. Co-operators General Insurance Company, 2011 ONFSCDRS 5

Arbitration application deemed withdrawn and expenses awarded after applicant abandoned the proceeding and failed to attend.

The applicant applied for statutory accident benefits following a motor vehicle accident.

After filing the application for arbitration, the applicant failed to communicate with his representative or attend scheduled pre-hearings.

The representative brought a motion to be removed from the record, and the insurer brought a motion to dismiss the claim without a hearing.

The arbitrator granted the representative's motion to be removed due to a breakdown in the relationship.

Rather than dismissing the claim as frivolous or vexatious under Rule 68, the arbitrator deemed the application withdrawn under Rule 70.3 due to the applicant's non-participation.

The applicant was ordered to pay $1,000 in expenses to the insurer for failing to attend proceedings.

OFSCDRSJan 12, 2011

Sarfaz A. Choudry v. State Farm Mutual Automobile Insurance Company, 2011 ONFSCDRS 4

Motion to appoint litigation guardian denied; insufficient evidence to rebut presumption of capacity.

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

During the arbitration process, the applicant's representative sought adjournments to appoint a litigation guardian, citing concerns about the applicant's capacity to instruct counsel.

The arbitrator held a preliminary issue hearing to determine if the applicant required a representative and if the application should be dismissed for delay.

The arbitrator found the medical and observational evidence insufficient to rebut the presumption of capacity, concluding the applicant could act on his own behalf.

The insurer's request to dismiss the application was denied, and the matter was ordered to proceed to a pre-hearing.

OFSCDRSJan 12, 2011

Cassondra Bouchard v. Motors Insurance Corporation, 2011 ONFSCDRS 3

Pocket bike deemed an automobile under the Insurance Act; applicant involved in an accident.

The applicant was injured while riding a gas-powered 'pocket bike' on private property and applied for statutory accident benefits.

The insurer denied the claim, arguing the pocket bike was not an 'automobile' and therefore no 'accident' occurred.

The arbitrator found that the pocket bike met the definition of an off-road vehicle under the Off-Road Vehicles Act.

Because the owner had previously driven it on lands they did not occupy, it was required to be insured under that Act.

Consequently, it fell within the expanded definition of 'automobile' under section 224(1)(a) of the Insurance Act, meaning the applicant was involved in an accident and entitled to claim benefits.

OFSCDRSJan 7, 2011

Jaswant Kaur v. Personal Insurance Company of Canada, 2010 ONFSCDRS 153

Unlicensed family member permitted to represent applicant at arbitration upon filing sworn declarations regarding non-compensation.

The applicant sought a caregiver benefit following a motor vehicle accident.

At a preliminary hearing, the arbitrator questioned whether the applicant's son-in-law, who is not a licensed legal practitioner, could represent her, and whether the applicant could participate by teleconference from India.

The arbitrator ruled that the son-in-law could represent the applicant only if both filed sworn declarations confirming he would receive no compensation and that any benefits would go solely to the applicant.

The issue of the teleconference hearing was deferred until the representation issue was resolved.

The insurer's request for expenses against the son-in-law personally was dismissed as he was not receiving compensation.

OFSCDRSDec 29, 2010

Jacqueline Warvill v. Personal Insurance Company of Canada, 2010 ONFSCDRS 154

Arbitration application dismissed as statute-barred for failing to commence proceedings within the two-year limitation period.

The applicant was involved in a motor vehicle accident and applied for a non-earner benefit, which the insurer denied.

The applicant applied for arbitration more than two years after the denial and more than 90 days after the mediator's report.

The arbitrator held that the insurer's denial was clear and unequivocal, and the applicant was barred from proceeding to arbitration due to the expiry of the limitation period under the Insurance Act and the Statutory Accident Benefits Schedule.

OFSCDRSDec 29, 2010

Michael Vieira v. Aviva Canada Inc., 2012 ONFSCDRS 60

Hoang v. Personal Insurance Company of Canada, 2012 ONFSCDRS 53

Jaswant Kaur v. Personal Insurance Company of Canada, 2012 ONFSCDRS 50

Michael Vieira v. Aviva Canada Inc., 2012 ONFSCDRS 29

Marcia Henry v. State Farm Mutual Automobile Insurance Company, 2012 ONFSCDRS 21

Michael Vieira v. Aviva Canada Inc., 2011 ONFSCDRS 110

Qadeer Osmani v. Economical Mutual Insurance Company, 2011 ONFSCDRS 90

Christopher Hoang (A Minor By His Litigation Guardian, San Trieu) v. Personal Insurance Company of Canada, 2011 ONFSCDRS 84

Jaswant Kaur v. Personal Insurance Company of Canada, 2011 ONFSCDRS 67

Luis Almeida v. Lombard General Insurance Company of Canada, 2011 ONFSCDRS 51

Leon Francis Rocheleau v. Allstate Insurance Company of Canada, 2011 ONFSCDRS 49

Abdirizzak Hassan Ismail v. State Farm Mutual Automobile Insurance Company, 2011 ONFSCDRS 34

Luis Almeida v. Lombard General Insurance Company of Canada, 2011 ONFSCDRS 33

Rosa Benjamin v. Belair Insurance Company Inc., 2011 ONFSCDRS 24

Daniel Prete v. State Farm Mutual Automobile Insurance Company, 2011 ONFSCDRS 7

Fong-Wai Lawrence Huang v. Co-operators General Insurance Company, 2011 ONFSCDRS 5

Sarfaz A. Choudry v. State Farm Mutual Automobile Insurance Company, 2011 ONFSCDRS 4

Cassondra Bouchard v. Motors Insurance Corporation, 2011 ONFSCDRS 3

Jaswant Kaur v. Personal Insurance Company of Canada, 2010 ONFSCDRS 153

Jacqueline Warvill v. Personal Insurance Company of Canada, 2010 ONFSCDRS 154

for Allstate Insurance Company of Canada

for Alon Rooz, personally and the firm of Mazin & Rooz

for American Home Assurance Company

for Aviva Canada Inc.

for Belair Insurance Company Inc.

for Certas Direct Insurance Company

for Christopher Hoang (A Minor By His Litigation Guardian, San Trieu)

for Co-operators General Insurance Company

for Coseco Insurance Co./HB Group/Direct Protect

for Dominion of Canada General Insurance Company

for Economical Mutual Insurance Company

for Farmers' Mutual Insurance Company

for Gore Mutual Insurance Company

for Guarantee Company of North America

for himself

for ING Insurance Company of Canada

for Kingsway General Insurance Company

for Liberty Insurance Company of Canada

for Lombard General Insurance Company of Canada

for Louis Mostyn

for Motors Insurance Corporation

for Motor Vehicle Accident Claims Fund

for Mr. Almeida, who did not attend

for Mr. Berry

for Mr. Bhola

for Mr. Brookes

for Mr. Choudry

for Mr. Claybourne

for Mr. Duong

for Mr. Fedoseev

for Mr. Fernandes

for Mr. Forbes

for Mr. Hoang

for Mr. Ismail

for Mr. Ives

for Mr. Jadavji

for Mr. Kabala

for Mr. Kainth

for Mr. Kanapathipillai

for Mr. Krishnapillai

for Mr. Kulmie

for Mr. Ladhar

for Mr. Lloyd

for Mr. Lyashov

for Mr. Mannarino

for Mr. Morgan

for Mr. M.'s Estate

for Mr. Novakovic

for Mr. Osmani

for Mr. Panchenko

for Mr. Plummer

for Mr. Prete

for Mr. Prince

for Mr. Puspanathan

for Mr. Razmjou

for Mr. Rocheleau

for Mrs. Flutur

for Mrs. Gabrielyan

for Mrs. Garg

for Mrs. Gonsalves