Jamie Robin Pollack

The Court of Appeal for Ontario considered whether arbitrators may order a higher-priority automobile insurer to reimburse a lower-priority insurer for pre-arbitration expenses incurred in handling a Statutory Accident Benefits (SABs) claim, outside the specific circumstances set out in Ontario Regulation 283/95.

The court held that, except in cases of improper deflection as provided in s. 2.1(7) of the regulation, arbitrators do not have authority to order such reimbursement.

The appeal was allowed, restoring the arbitrator’s decision that Unifund was not required to reimburse Echelon for its pre-arbitration expenses.

This motion concerned an application for judicial approval of a settlement for statutory accident benefits (SABS) for a catastrophically injured claimant who lacked capacity to instruct counsel.

The court expressed significant concerns regarding the adequacy of the proposed settlement amount, the fairness and applicability of the contingency fee agreement to a SABS claim, the claimant's capacity at the time of signing the fee agreement and various loans, and the absence of a proper management plan for the lump sum payment.

The court refused to approve the settlement as proposed and referred the matter to the Office of the Public Guardian and Trustee for further input, remaining seized of the matter.

An insurer mistakenly believed that a snowmobile was not covered under its automobile insurance policy and persuaded the Motor Vehicle Accident Claims Fund to accept responsibility for paying statutory accident benefits to an injured passenger.

When the coverage error was discovered, the Fund sought reimbursement and the insurer refused, arguing that the Fund had lost its ability to contest priority once it accepted responsibility.

The arbitrator found the insurer was the priority insurer and ordered reimbursement.

The Court of Appeal upheld the decision, holding that the Fund is not an ordinary insurer in priority disputes under the Regulation and is entitled to resile from its acceptance of priority.

The court also clarified that section 7(6) of the Regulation permits an arbitrator to order full reimbursement of benefits paid, not merely impose sanctions.

The appellant, Travelers Insurance Company, appealed an arbitrator's decision that it was the priority insurer for statutory accident benefits following an accident in Nunavut.

The arbitrator found Travelers liable because it was an Ontario insurer, had filed a Power of Attorney and Undertaking (PAU) in Ontario, and was the insurer of the car involved.

Travelers argued the arbitrator erred by applying Ontario law to a Nunavut policy without first determining if the policy provided Ontario benefits coverage.

The court upheld the arbitrator's decision, finding that the standard of review was reasonableness and that Travelers, as an Ontario-licensed insurer and PAU signatory, was bound by Ontario's priority laws, precluding it from denying coverage based on the accident's location.

The Minister of Finance appealed an arbitration award that found the Motor Vehicle Accident Claims Fund, not Echelon General Insurance Company, liable for statutory accident benefits (SABs) to an injured pedestrian.

The arbitrator had concluded that the insured's email constituted a valid request to terminate his automobile insurance policy, thereby absolving Echelon of liability.

The Minister argued the arbitrator's decision was unreasonable, contending the email was not a clear request, the context of Echelon's prior ineffective cancellation was ignored, and the decision frustrated consumer protection policies.

The court dismissed the Minister's appeal, finding the arbitrator's interpretation of "request" under the Statutory Conditions was reasonable and consistent with case law, which imposes no formal requirements on an insured's termination request.

The Motor Vehicle Accident Claims Fund (Fund) appealed an arbitrator's decision that allowed it to withdraw its acceptance of priority for accident benefits.

Echelon General Insurance Company (Echelon) had initially notified the Fund that a snowmobile involved in an accident was uninsured, leading the Fund to accept priority.

The Fund later discovered Echelon's policy actually covered the snowmobile and sought restitution.

The arbitrator found Echelon failed to conduct a reasonable investigation as required by O. Reg. 283/95, s. 3.1, making its notice to the Fund improper.

The court upheld the arbitrator's decision, finding that the Fund was not an "insurer" under the regulation and had specific, different treatment, including an exemption from the strict rules preventing withdrawal of priority acceptance.

The court affirmed that Echelon's failure to conduct a reasonable investigation meant no proper priority dispute was raised, and Echelon remained the priority insurer.