Applicant's failure to attend arbitration resulted in dismissal of benefits and an expense award to the insurer.
The applicant applied for statutory accident benefits following a motor vehicle accident but failed to appear at the arbitration hearing.
His claims for income replacement, medical, and rehabilitation benefits were dismissed for lack of evidence.
The insurer sought an award under section 282(11.2) of the Insurance Act, alleging the claim was fraudulent and an abuse of process.
The arbitrator dismissed this request, finding the insurer failed to prove fraud from the outset on a balance of probabilities, as required to trigger the section.
However, the arbitrator awarded the insurer $4,776.02 in expenses under the Expense Regulation, as the applicant's failure to appear rendered his claims manifestly unfounded.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesMay 10, 2001
