Mary Meropoulos

The appellant appealed an arbitration order finding that she was not an 'insured person' under the respondent's automobile insurance policy.

The appellant had submitted an application for accident benefits to the respondent, who was the first insurer to receive a completed application.

The respondent denied the claim on the basis of coverage, arguing she was not an insured person.

The Director of Arbitrations allowed the appeal, holding that under the Priorities Regulation (O. Reg. 283/95), the first insurer to receive a completed application must pay benefits pending the resolution of any priority dispute.

The Director found that the arbitrator erred in treating the issue as a coverage dispute rather than a priority dispute, and that the respondent was obliged to respond to the claim and could only shift responsibility by following the procedures in the Priorities Regulation.

The applicant was injured while fleeing a multi-vehicle collision as a pedestrian.

She applied for statutory accident benefits from Royal, claiming she was an insured person under her son's automobile insurance policy.

Royal responded as the first insurer but denied she was an insured person.

The arbitrator found that the applicant was not listed on the policy and rejected her claim that there was a binding oral contract to include her, applying the parol evidence rule.

The arbitrator concluded the applicant was not an 'insured person' under the policy and not entitled to seek further accident benefits from Royal.

The applicant was injured while attempting to avoid a collision as a pedestrian and applied for statutory accident benefits from the insurer.

The parties proceeded to arbitration on three preliminary issues.

After hearing evidence on the first preliminary issue, the arbitrator declined to issue a decision immediately, finding it necessary in the interests of fairness and efficiency to reserve the decision until the hearing concluded with respect to all three preliminary issues.