2 total
Applicants found to have been involved in an 'accident' despite insurer's staged collision allegations.
The applicants claimed statutory accident benefits following a reported hit-and-run motor vehicle collision.
The insurer denied the claims, arguing the applicants were not involved in an 'accident' as defined in the Schedule and putting them to strict proof that the collision occurred as reported.
Following a preliminary issue hearing, the arbitrator found the applicants' evidence credible and corroborated by circumstantial evidence, while finding the insurer's accident reconstruction evidence unpersuasive.
The arbitrator concluded that the applicants were involved in an accidental collision and were therefore involved in an 'accident' under subsection 2(1) of the Schedule.
Applicants disentitled to accident benefits for wilfully misrepresenting that the passenger was driving the vehicle.
The applicants sought accident benefits following a motor vehicle accident, claiming that Ms. Hoey was driving the vehicle.
The insurer terminated benefits, alleging that Mr. Vera, whose license was suspended, was actually driving and that the applicants wilfully misrepresented this material fact.
Following a preliminary issue hearing, the arbitrator found that the preponderance of evidence, including independent witness testimony and Mr. Vera's actions at the scene, established that Mr. Vera was the driver.
The arbitrator concluded that both applicants wilfully misrepresented material facts, disentitling them to benefits, and awarded the insurer its reasonable expenses.
