Insurer ordered to pay statutory accident benefits pending final resolution of workers' compensation entitlement dispute.
The applicant was injured in a motor vehicle accident while driving to a job site.
He applied for statutory accident benefits from the insurer and workers' compensation benefits from the WSIB.
The WSIB determined that the applicant was not entitled to WSIB benefits because the claim was filed beyond the six-month limitation period.
The insurer argued that the applicant was entitled to WSIB benefits and that it was not required to pay statutory accident benefits under section 59(1) of the Statutory Accident Benefits Schedule.
The arbitrator held that, as the WSIB had determined the applicant was not entitled to benefits, section 59(1) did not relieve the insurer of its obligation to pay.
The arbitrator further ordered the insurer to pay benefits pending the final resolution of the WSIB dispute, pursuant to section 59(5) of the Schedule.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMar 7, 2005