Michael Spagnolo

The applicant insurer sought judicial review of a FSCO Director's Delegate decision that allowed an insured's appeal in part regarding statutory accident benefits.

The insurer had denied claims for an in-home assessment and form preparation, alleging the clinics were engaged in a fraudulent scheme.

The Divisional Court held that the Director's Delegate exceeded his jurisdiction by interfering with the Arbitrator's findings of fact regarding the in-home assessment, as appeals are limited to questions of law.

However, the court upheld the decision requiring the insurer to pay for form preparation because the insurer failed to object to the application within the statutory timeframe.

The applicant sought judicial review of an arbitrator's decision regarding Statutory Accident Benefits without first appealing to the Director's Delegate as required by s. 283(1) of the Insurance Act.

After a previous stay, the applicant's late appeal to the Director's Delegate was dismissed.

The Divisional Court dismissed the current application for judicial review, holding that it lacked jurisdiction to review the arbitrator's decision directly and that the applicant must instead seek judicial review of the Director's Delegate's final decision.