John Wilson is a arbitrator at the Ontario Financial Services Commission - Dispute Resolution Services with 216 decisions on record from 1999 to 2016. Key areas include statutory accident benefits schedule matters (sabs), other tribunals, administrative law.

What tribunal does John Wilson sit on?

John Wilson sits on the Ontario Financial Services Commission - Dispute Resolution Services.

What areas of law does John Wilson decide?

John Wilson's most common areas include Statutory Accident Benefits Schedule matters (SABS) (212 decisions), Other Tribunals (74 decisions), Administrative Law (25 decisions). John Wilson has handled 216 decisions across 9 areas.

How many decisions has John Wilson made?

John Wilson has 216 decisions on record from 1999 to 2016.

Who frequently appears before John Wilson?

Representatives who frequently appear before John Wilson include Ian D. Kirby, Jamie Pollack, Grant R. Dow.

John Wilson — Arbitrator

Christina Zaia and Freda Zaia v. Unica Insurance Inc., 2016 ONFSCDRS 236

Insurer's motion for production partially granted; third-party orders denied for lack of evidentiary support.

The insurer brought a motion to compel the applicants and certain third parties to produce various documents, including medical records, WSIB files, and employment files, in a dispute over statutory accident benefits following a motor vehicle accident.

The arbitrator denied the requests for third-party production due to a lack of evidentiary support demonstrating that the documents were reasonably required for a fair hearing.

However, the arbitrator ordered the applicants to produce or update certain records within their control, such as updated clinical notes, collateral benefits information, and contact details for service providers, while denying requests for unidentified or irrelevant records.

OFSCDRSSep 7, 2016

Louis Antoniadis v. TD General Insurance Company, 2016 ONFSCDRS 234

Arbitration of accident benefits claims dismissed for abandonment following the applicant's death.

The insurer brought a motion to dismiss the arbitration of statutory accident benefits claims due to abandonment.

The applicant had passed away, and there had been no progress in the arbitration for an extended period.

The estate's representative consented to the dismissal, provided it was suspended for 30 days to allow for settlement discussions.

The 30-day period elapsed without any notice of intent to continue the arbitration from a duly appointed estate representative.

Consequently, the arbitrator dismissed the claims.

OFSCDRSSep 6, 2016

Kofi Agyapong v. Jevco Insurance Company, 2016 ONFSCDRS 233

Insurer's costs reduced by one-third due to unreasonable conduct in reviving a settled preliminary issue.

The insurer sought its expenses after successfully defending the applicant's claim in its entirety.

The applicant argued that no expenses should be payable or that they should be reduced because the insurer unreasonably attempted to revive a preliminary issue regarding time limits after having settled it.

The arbitrator agreed that the insurer's conduct unnecessarily prolonged the hearing.

As roughly one-third of the hearing time was devoted to the preliminary matters decided against the insurer, the arbitrator awarded the insurer two-thirds of its claimed legal expenses, plus full disbursements and HST, totaling $16,144.23.

OFSCDRSSep 2, 2016

Amir Kermanshah v. Personal Insurance Company of Canada, 2016 ONFSCDRS 182

Arbitration dismissed as abandoned and vexatious after applicant failed to communicate with counsel or attend proceedings.

The applicant's counsel brought a motion to be removed from the record after the applicant failed to communicate or provide instructions following mediation.

The arbitrator granted the motion to withdraw.

The insurer subsequently brought a motion to dismiss the arbitration as abandoned and vexatious, noting the applicant's failure to attend the pre-hearing or respond to communications.

The arbitrator found that the applicant had effectively abandoned his claims and that continuing the arbitration would be an abuse of process.

The arbitration was dismissed, and the applicant was ordered to pay the insurer's expenses fixed at $2,772.07.

OFSCDRSJun 30, 2016

Vincent Sinclair v. Unifund Assurance Company, 2016 ONFSCDRS 178

Arbitration application dismissed because the specific issue of non-earner benefits was not mediated.

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

He sought arbitration for non-earner benefits.

The insurer raised a preliminary issue that the applicant had not mediated the issue of non-earner benefits, as the mediation report only referred to income replacement benefits.

The arbitrator held that mediation of the specific issue is a statutory precondition to arbitration under section 281(2) of the Insurance Act.

The arbitrator rejected the applicant's arguments regarding fundamental breach and relief from forfeiture, finding no jurisdiction to grant relief from forfeiture and that the mediation requirement is not an exclusion clause.

The application for arbitration was dismissed.

OFSCDRSJun 23, 2016

Ying Al Chen v. State Farm Mutual Automobile Insurance Company, 2016 ONFSCDRS 155

Arbitrator dismisses accident benefits claims, finding deemed approval provisions do not override reasonable and necessary requirements.

The applicant sought payment for a family and social assessment and custom orthotics following a motor vehicle accident.

The applicant argued that the insurer failed to respond to the treatment plans within the required time, resulting in deemed approval under the Statutory Accident Benefits Schedule.

The arbitrator held that the deemed approval provisions relate to the timing of interim payments pending dispute resolution and do not override the substantive requirement that expenses be reasonable and necessary.

The arbitrator found insufficient evidence to prove the treatment plans were properly submitted or that the claimed expenses were reasonable and necessary.

The claims were dismissed.

OFSCDRSMay 30, 2016

Zuhail Khan v. State Farm Mutual Automobile Insurance Company, 2016 ONFSCDRS 136

Application for catastrophic impairment and ongoing accident benefits dismissed due to lack of medical evidence proving causation.

The self-represented applicant sought a determination of catastrophic impairment and ongoing housekeeping and non-earner benefits following a motor vehicle accident.

The applicant suffered from pre-existing schizophrenia and other mental health challenges.

The arbitrator found that the applicant failed to meet the evidentiary burden of proving a whole person impairment in excess of 55% under the AMA Guides, or that his psychological deterioration was caused by the accident rather than his pre-existing condition.

As the applicant was not found to be catastrophically impaired and had exhausted his non-catastrophic limits, the claims for further housekeeping and non-earner benefits were dismissed.

OFSCDRSMay 6, 2016

Kofi Agyapong v. Jevco Insurance Company, 2016 ONFSCDRS 37

Accident benefits claims dismissed as applicant failed to prove impairments were caused by the subject accident.

The applicant sought non-earner and housekeeping benefits following a motor vehicle accident.

The insurer initially conceded a limitations defence but attempted to withdraw the concession on the eve of the hearing; the arbitrator found this inequitable based on promissory estoppel.

On the merits, the arbitrator found the applicant failed to prove causation under either the 'but for' or 'material contribution' tests, noting the applicant's extensive pre-existing physical and psychological conditions from prior accidents and assaults.

The claims for non-earner and housekeeping benefits were dismissed.

OFSCDRSJan 25, 2016

Muirhead v. Dominion of Canada General Insurance Company, 2015 ONFSCDRS 136

Arbitrator orders production of police investigation file in accident benefits dispute applying Wagg principles.

The applicant was injured while riding as a passenger on an ATV.

The insurer denied certain accident benefits on the basis that the applicant knew or ought to have known the driver was operating the ATV without the owner's consent.

The applicant brought a motion for the production of the Ontario Provincial Police investigation file.

The arbitrator held that under section 22 of the Insurance Act, a FSCO arbitrator has the power to issue a Wagg order compelling the production of police records.

As the OPP and Attorney General were served but did not appear to assert any public interest immunity, and the documents were already vetted in a related tort action, the arbitrator ordered the OPP to produce the unredacted file.

OFSCDRSJun 26, 2015

Catherine Yeboah v. Economical Mutual Insurance Company, 2015 ONFSCDRS 109

Applicant ordered to pay $4,865.43 in expenses after abandoning a concocted accident benefits claim.

Following the dismissal of the applicant's claim for statutory accident benefits, the insurer sought its expenses for the arbitration.

The applicant had failed to attend the hearing and her claim was found to have been concocted.

The arbitrator reviewed the insurer's bill of costs, which included legal fees capped at the legal aid tariff rate and disbursements including an engineering report and travel expenses.

The arbitrator found the claimed expenses reasonable and ordered the applicant to pay $4,865.43 to the insurer.

OFSCDRSMay 21, 2015

Fee Nung Wong v. St. Paul Fire & Marine Insurance Company, 2015 ONFSCDRS 95

Successful insurer awarded $5,000 in arbitration expenses, reduced to reflect applicable legal aid tariff rates.

Following the dismissal of the applicant's claim for statutory accident benefits, the successful insurer sought its expenses for the arbitration.

The arbitrator found the insurer was entitled to expenses, noting it had bettered its offer to settle and the issues were not novel.

However, the arbitrator reduced the claimed amount because the insurer's counsel incorrectly billed at the higher hourly rate reserved for an insured person's counsel under the Dispute Resolution Practice Code, rather than the applicable legal aid tariff rate.

Costs were fixed at $5,000.00 inclusive of HST.

OFSCDRSMay 1, 2015

Villard Alex Vitalis v. Intact Insurance Company, 2015 ONFSCDRS 93

Accident benefits claim dismissed as abandoned due to applicant's complete failure to participate in arbitration.

The applicant claimed statutory accident benefits following a motor vehicle accident but failed to participate in the arbitration process or provide contact information.

The insurer moved to dismiss the claim as abandoned.

The arbitrator found that the applicant's ongoing failure to attend hearings or communicate with his counsel constituted an abuse of process.

The claim was dismissed as frivolous and vexatious under Rule 68 of the Dispute Resolution Practice Code, and the applicant was ordered to pay the insurer's reasonable expenses.

OFSCDRSApr 29, 2015

Velluppillai Thanikasalam v. State Farm Mutual Automobile Insurance Company, 2015 ONFSCDRS 71

Insured ordered to pay $6,264.50 in expenses after abandoning arbitration and failing to attend hearing.

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

After the applicant failed to attend the arbitration hearing, his claims were dismissed and the insurer was awarded its expenses.

In this decision on expenses, the arbitrator assessed the insurer's bill of costs.

The arbitrator reduced the claimed hourly rate, noting that the enhanced rate under Rule 78.1 of the Dispute Resolution Practice Code applies only to insured persons, not insurers, and limited the rate to the prevailing legal aid tariff.

The applicant was ordered to pay $6,264.50 in fixed expenses to the insurer.

OFSCDRSApr 10, 2015

Badria Firin v. State Farm Mutual Automobile Insurance Company, 2015 ONFSCDRS 50

Arbitration dismissed as an abuse of process after applicant abandoned claim and ignored orders.

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

After her counsel was removed from the record due to a breakdown in the lawyer-client relationship, the applicant failed to attend a scheduled pre-hearing and failed to comply with an order requiring her to confirm her intention to continue the arbitration.

The insurer brought a motion to dismiss the arbitration.

The arbitrator granted the motion, finding that the applicant's ongoing refusal to obey arbitral orders and participate in the process constituted an abuse of process, rendering the proceeding frivolous and vexatious under section 4.6(1) of the Statutory Powers Procedure Act.

The claims were dismissed, and the insurer was awarded its reasonable expenses.

OFSCDRSMar 16, 2015

Ivana Vukov v. Aviva Canada Inc., 2015 ONFSCDRS 49

Insurer awarded $18,403.89 in expenses after applicant abandoned hearing; out-of-town counsel travel costs disallowed.

Following the dismissal of the applicant's claims for statutory accident benefits after she abandoned the arbitration hearing, the insurer sought its expenses.

The insurer claimed $19,355.53 in fees and disbursements.

The arbitrator found the fees reasonable based on the legal aid tariff but disallowed $1,951.64 in travel-related expenses and associated HST, noting the insurer chose to retain out-of-town counsel without justification.

The applicant was ordered to pay fixed expenses of $18,403.89.

OFSCDRSMar 13, 2015

Abdi Hassan v. State Farm Mutual Automobile Insurance Company, 2015 ONFSCDRS 44

Accident benefits claim barred and repayment of $41,036.44 ordered due to wilful misrepresentation of material facts.

The applicant applied for statutory accident benefits following an alleged motor vehicle accident.

The insurer terminated benefits and brought a motion to dismiss the arbitration and seek repayment, alleging the applicant wilfully misrepresented material facts about the accident and his claim for housekeeping benefits.

The arbitrator found that the applicant failed to provide evidence to rebut the insurer's prima facie case of misrepresentation, noting significant inconsistencies in his account of the accident and claims for housekeeping services that were never provided.

The arbitrator concluded the applicant intentionally misled the insurer.

The applicant's claim was barred, and he was ordered to repay $41,036.44 in benefits received as a result of the misrepresentation.

OFSCDRSMar 10, 2015

Dianna Asuming v. Belair Insurance Company Inc., 2014 ONFSCDRS 134

Arbitration application for accident benefits dismissed due to applicant's failure to attend the hearing.

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

After parting ways with her counsel, the applicant failed to attend a pre-hearing and the scheduled arbitration hearing.

The arbitrator dismissed the application, finding that the applicant's failure to participate constituted an abuse of process and that she failed to meet her burden of proof.

The applicant was ordered to pay the insurer's expenses of $1,089.51.

OFSCDRSAug 15, 2014

Stephanie Kelly v. Guarantee Company of North America, 2014 ONFSCDRS 128

Retroactive Form 1 permitted for attendant care benefits; family and hospital services deemed incurred.

The Applicant was catastrophically injured in a motor vehicle accident and received supplementary attendant care services from her parents and a hospital.

No Form 1 was completed at the time.

Years later, an occupational therapist completed a retroactive Form 1.

The Insurer refused to pay, arguing a Form 1 cannot be retroactive and the expenses were not incurred.

The Arbitrator held that the Schedule does not prohibit a retroactive Form 1 and that the services provided by family and the hospital were 'incurred'.

The Insurer was ordered to pay the attendant care benefits, the cost of the Form 1, interest, and expenses.

OFSCDRSAug 7, 2014

Thanikasalam v. State Farm Mutual Automobile Insurance Company, 2014 ONFSCDRS 113

Arbitration claims dismissed and representative's motion to withdraw denied after applicant failed to attend hearing.

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

The matter proceeded to an arbitration hearing, but the applicant failed to attend.

At the hearing, the applicant's representative brought a motion to be removed from the record, citing an inability to contact his client.

The arbitrator denied the motion, finding that the representative forfeited the right to withdraw by waiting until the hearing itself without extenuating circumstances.

The insurer requested that the applicant's claims be dismissed due to his non-attendance.

The arbitrator dismissed the claims, noting the applicant failed to provide evidence to support his case, and awarded expenses to the insurer.

OFSCDRSJul 7, 2014

Michaud v. State Farm Mutual Automobile Insurance Company, 2014 ONFSCDRS 108

Arbitration claims for accident benefits dismissed due to applicants' ongoing refusal to attend examinations under oath.

The insurer brought a motion to dismiss the applicants' arbitration claims for accident benefits.

The applicants had repeatedly failed to attend examinations under oath, despite an earlier finding that they were required to do so and an undertaking by their counsel to produce them.

The arbitrator found that the applicants' ongoing refusal to participate in the claims process while continuing to advance their arbitration claims constituted an abuse of process.

The arbitration applications were dismissed.

OFSCDRSJun 27, 2014

Christina Zaia and Freda Zaia v. Unica Insurance Inc., 2016 ONFSCDRS 236

Louis Antoniadis v. TD General Insurance Company, 2016 ONFSCDRS 234

Kofi Agyapong v. Jevco Insurance Company, 2016 ONFSCDRS 233

Amir Kermanshah v. Personal Insurance Company of Canada, 2016 ONFSCDRS 182

Vincent Sinclair v. Unifund Assurance Company, 2016 ONFSCDRS 178

Ying Al Chen v. State Farm Mutual Automobile Insurance Company, 2016 ONFSCDRS 155

Zuhail Khan v. State Farm Mutual Automobile Insurance Company, 2016 ONFSCDRS 136

Kofi Agyapong v. Jevco Insurance Company, 2016 ONFSCDRS 37

Muirhead v. Dominion of Canada General Insurance Company, 2015 ONFSCDRS 136

Catherine Yeboah v. Economical Mutual Insurance Company, 2015 ONFSCDRS 109

Fee Nung Wong v. St. Paul Fire & Marine Insurance Company, 2015 ONFSCDRS 95

Villard Alex Vitalis v. Intact Insurance Company, 2015 ONFSCDRS 93

Velluppillai Thanikasalam v. State Farm Mutual Automobile Insurance Company, 2015 ONFSCDRS 71

Badria Firin v. State Farm Mutual Automobile Insurance Company, 2015 ONFSCDRS 50

Ivana Vukov v. Aviva Canada Inc., 2015 ONFSCDRS 49

Abdi Hassan v. State Farm Mutual Automobile Insurance Company, 2015 ONFSCDRS 44

Dianna Asuming v. Belair Insurance Company Inc., 2014 ONFSCDRS 134

Stephanie Kelly v. Guarantee Company of North America, 2014 ONFSCDRS 128

Thanikasalam v. State Farm Mutual Automobile Insurance Company, 2014 ONFSCDRS 113

Michaud v. State Farm Mutual Automobile Insurance Company, 2014 ONFSCDRS 108

amicus curiae

appearing on her own behalf

assistance for the Applicant

assisted Mrs. Alamin

assisted Mr. Shemou

assisted Ray McCormack

community advisor for Aba M. Alamin

counsel for the OPP

for ACE INA Insurance

for Allianz Insurance Company of Canada

for Allstate Insurance Company of Canada

for Aviva Canada Inc.

for Aviva Canada Inc. (formerly CGU Group)

for Belair Insurance Company Inc.

for Canada Life Casualty Insurance Company

for Cecilia Ampong and Paul Gyeni

for Certas Direct Insurance Company

for CGU Insurance Company of Canada

for Citadel General Assurance Company

for Commercial Union Assurance Company

for Co-operators General Insurance Company

for Coseco Insurance Co./HB Group/Direct Protect

for Dominion of Canada General Insurance Company

for Dr. Lewchuk

for Dufferin Mutual Insurance Company

for Economical Mutual Insurance Company

for Gino Isabella

for Gore Mutual Insurance Company

for Guarantee Company of North America

for Guardian Insurance Company of Canada

for Halifax Insurance Company

for herself

for himself

for himself as moving party

for H.T.

for ING Insurance Company of Canada

for Intact Insurance Company

for Jevco Insurance Company

for Kingsway General Insurance Company

for Liberty Insurance Company of Canada

for Liberty Mutual Insurance Company

for Lofranco Scarola Wentzel Legal Services

for Lombard General Insurance Company of Canada

for Markel Insurance Company of Canada

for Moira Gracey

for Motors Insurance Corporation

for Motor Vehicle Accident Claims Fund

for Mr. Ablarde

for Mr. Agyapong

for Mr. Ahmed

for Mr. Alexander Mazin

for Mr. Al-Hajam

for Mr. Allen

for Mr. Aloise

for Mr. Alon Rooz

for Mr. and Mrs. Gurevich

for Mr. Antoniadis

for Mr. Ash

for Mr. Berger

for Mr. Berhe