Rohit Sethi

This appeal arose from a priority dispute between insurance companies concerning accident benefits coverage following a motor vehicle accident.

The appellant, Trafalgar Insurance Company, appealed an arbitration decision that found the injured party was not insured by Economical Insurance Company and not entitled to Statutory Accident Benefits from them.

The Superior Court dismissed the appeal, upholding the arbitrator's findings that the vehicle in question was not an 'owned automobile' under Economical's standard Ontario Garage Policy (OAP 4) because its use (leased to a rental company) was outside the scope of the insured's business and was specifically excluded by the policy.

The court also affirmed that section 233(2) of the Insurance Act did not apply as the issue was the vehicle's insured status, not a breach of contract or misrepresentation.

The appellants, Trafalgar Insurance and Economical Insurance, appealed an arbitrator's decision in a priority dispute regarding statutory accident benefits.

The arbitrator had found that Arch Insurance was not the insurer of the vehicle involved in the accident because the vehicle was not owned or leased by Arch's named insured, despite being mistakenly listed on a fleet schedule.

The Superior Court of Justice dismissed the appeal, finding no palpable and overriding error or error of law in the arbitrator's conclusion that the vehicle did not qualify as a 'described vehicle' under the OPCF 21A endorsement.

A related costs appeal was also dismissed as premature.

The appellant appealed a Master's order refusing to set aside a Registrar's administrative dismissal of his civil action under Rule 48.14(1).

The Divisional Court found that the Master erred in law and made palpable and overriding errors of fact by incorrectly applying the test for setting aside an administrative dismissal.

Specifically, the Master failed to consider all factors, such as promptness and prejudice, and ignored certified information provided by counsel in a Simplified Procedure motion form.

The appeal was allowed, the Master's order was set aside, and the action was ordered to be set down for trial.

Belair Insurance Company appealed an arbitrator's decision that found it 100% at fault for indemnifying State Farm Mutual Automobile Insurance Company for statutory accident benefits under a loss transfer dispute.

The Superior Court of Justice reviewed the arbitrator's interpretation of the Fault Determination Rules, specifically rules 12(5) and 13(2), under a reasonableness standard.

The arbitrator had concluded that Rule 13(2) did not apply to incidents involving vehicles travelling in opposite directions in adjacent lanes at an uncontrolled intersection, as such scenarios were covered by Rule 12(5).

The court upheld the arbitrator's interpretation, finding it reasonable and consistent with the legislative scheme's purpose of providing an expedient method for fault determination among insurers.

The appeal was dismissed.

The plaintiff was injured in a motor vehicle accident involving an American resident driver insured by GEICO.

The plaintiff issued a statement of claim just before the limitation period expired but was unable to locate and serve the American defendant for several years.

The plaintiff brought a motion to extend the time for service and for substituted service on the defendant's insurer.

During the reserve period of the motion, the defendant's insurer located the defendant.

The court granted the motion, finding that the plaintiff had taken reasonable steps to locate the defendant, provided an acceptable explanation for the delay, and the defendant would not suffer non-compensable prejudice.

An insurer appealed an arbitrator’s decision in a statutory accident benefits priority dispute under s. 268 of the Insurance Act.

The arbitration determined that the accident victim was principally dependent on his father and stepmother, making the father’s insurer responsible for statutory accident benefits reimbursement.

The appellant argued the arbitrator misapplied the dependency test and failed to conduct a proper mathematical analysis of financial support.

The court held the arbitrator correctly applied the dependency criteria established in Miller v. Safeco and that the conclusion that the claimant was not financially independent was both correct and reasonable.

The appeal was dismissed.

The insurer requested an expense hearing after the applicant's arbitration for statutory accident benefits was dismissed as frivolous and vexatious due to his failure to participate.

The applicant did not attend the expense hearing.

The arbitrator awarded the insurer $1,144.63 in expenses, finding that the applicant's conduct unnecessarily prolonged the proceedings.

The insurer's request for the applicant to pay the $3,000 arbitration filing fee was denied for lack of jurisdiction.