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The court upheld an arbitration decision finding an insurer liable for SABS benefits for a stolen ATV under a newly acquired automobile provision.
Farmers' Mutual Insurance Company (Lindsay) appealed an arbitration decision that found its commercial umbrella liability policy covered Statutory Accident Benefits Schedule (SABS) benefits for an all-terrain vehicle (ATV) accident.
The court, reviewing for reasonableness, found the arbitrator erred in interpreting the definition of 'automobile' within the Umbrella policy.
However, the court concluded that the ATV was covered under Farmers' standard Ontario Automobile Policy (OAP) via the 'Newly Acquired Automobiles' provision, due to the Umbrella policy's effect on the OAP's prerequisite that the insurer insure all automobiles owned by the insured.
Consequently, Farmers' appeal was dismissed, and the Minister of Finance's cross-appeal was allowed, affirming Farmers as the priority insurer responsible for SABS benefits.
Disputes over whether a claimant was involved in an 'accident' must proceed through the mandatory SABs dispute resolution scheme.
The appellant insurer appealed a decision dismissing its application for a preliminary determination of whether the respondent was involved in an 'accident' under the Statutory Accident Benefits Schedule.
The insurer argued this was a coverage issue that had to be determined by a court before the mandatory dispute resolution scheme under s. 279 of the Insurance Act applied.
The Court of Appeal dismissed the appeal, holding that the s. 279 scheme is a comprehensive alternative dispute resolution process that governs all disputes concerning entitlement to statutory accident benefits, including whether a claimant qualifies as an insured person involved in an accident.
Arbitration stayed pending applicant's completion of insurer examinations; service provider not required to produce further documents.
The insurer raised a preliminary issue seeking to stay the arbitration pending the applicant's attendance at an updated occupational therapy in-home assessment and a psychological examination under section 44 of the Statutory Accident Benefits Schedule.
The applicant argued the occupational therapy assessment was causing him severe physical and psychological distress.
The arbitrator ordered the arbitration stayed until the applicant completes the psychological assessment and the remaining functional testing for the occupational therapy assessment, though the latter could be conducted by a different occupational therapist.
The arbitrator also ruled that the applicant's service provider was not required to speak with the insurer's assessor or provide further documentation under section 46.2, as sufficient information had already been provided.
Application for accident benefits arbitration dismissed after applicant failed to participate; insurer awarded $750 expenses.
The applicant was injured in a motor vehicle accident and sought accident benefits from the insurer.
After the applicant failed to attend a pre-hearing discussion and his counsel lost contact with him, counsel successfully moved to withdraw.
The insurer subsequently moved to dismiss the application for arbitration.
The arbitrator granted the motion to dismiss under Rule 68 of the Dispute Resolution Practice Code, finding the application frivolous, vexatious, or commenced in bad faith due to the applicant's failure to participate.
The insurer was awarded $750 in expenses.
