5160 Yonge Street
14th Floor, Box 85
North York ON M2N 6L9
5160, rue Yonge
14e étage, Boîte 85
North York ON M2N 6L9
Dispute Resolution Group / Groupe de réglement des différends Arbitration Unit / Unité de l'arbitrage
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Neutral Citation: 1995 ONICDRG 156
File No.: A-012054
ONTARIO INSURANCE COMMISSION
BETWEEN:
Phinh Van Pham
Applicant
and
Pafco Insurance Company Limited
Insurer
ORDER
The Applicant was injured in a motor vehicle accident on February 28, 1994. The Applicant was insured under a standard automobile owner's policy issued by the Insurer. Every motor vehicle policy provides the benefits set out in the Statutory Accident Benefits Schedule - Accidents after January 1, 1994, Ontario Regulation 776/93 under the Insurance Act, R.S.O. 1990, c. I.8.
The Applicant and the Insurer disagree about the Applicant's entitlement to statutory accident benefits. The Applicant has applied for arbitration of the dispute under section 279 of the Insurance Act. The Insurer has made allegations that the Applicant's application for benefits is part of a scheme or class of claims in which fraudulent employment information is provided.
This MOTION, made by the Insurer for an Order that the following items be produced:
Accident benefit claims file of Ho, Hung Van re accident March 24, 1995 - Economical Mutual Insurance Company claim no. unknown, policy number 9863261, policyholder: Nguyen, Thi My Hien.
Accident benefit claims file of Mach, Dieu-Tai re accident April 10, 1995 - Economical Mutual Insurance Company claim no. unknown, policy number 9871164, policyholder: Chi Quang Ly, was heard this day, by telephone conference call among the Arbitrator, Mr. Michael Gillen, Barrister and Solicitor, on behalf of the Applicant, and Mr. Eric K. Grossman, Barrister and Solicitor, on behalf of the Insurer.
UPON HEARING submissions from counsel for the Applicant and the Insurer, it is ordered that the following items be produced to the Insurer and the Applicant by Economical Mutual Insurance Company on November 27, 1995, unless in the interim it is notified otherwise, in writing, by me:
Accident benefit claims file of Ho, Hung Van re accident March 24, 1995 - Economical Mutual Insurance Company claim no. unknown, policy number 9863261, policyholder: Nguyen, Thi My Hien, excepting any document relating to setting of claims reserve.
Accident benefit claims file of Mach, Dieu-Tai re accident April 10, 1995 - Economical Mutual Insurance Company claim no. unknown, policy number 9871164, policyholder: Chi Quang Ly, excepting any document relating to setting of claims reserve.
AND IT IS FURTHER ORDERED that a copy of this order be served forthwith by the Insurer on the Economical Mutual Insurance Company, c/o Jacqui Romandel, 5700 Yonge St., Suite 1600, North York M2M 4K2 by facsimile transmission or ordinary first class mail and forthwith on Dieu-Tai Mach, Chi Quang Ly, Hung Van Ho, and Thi My Hien Nguyen by ordinary first class mail at their last address as known by the Economical Mutual Insurance Company.
AND IT IS FURTHER ORDERED that if any of the Economical Mutual Insurance Company, Dieu-Tai Mach, Chi Quang Ly, Hung Van Ho or Thi My Hien Nguyen wish to make submissions to the Arbitrator in this case that they notify Chantal Laurin, Case Administrator, Ontario Insurance Commission at (416) 590-7114 by Friday, November 24, 1995 at 4:00 p.m.
November 1, 1995
K. Julaine Palmer
Arbitrator
Date
Copies to:
Mr. Michael Gillen
Walker, Fox & Schwarz
Barristers & Solicitors
2040 Yonge St.
Suite 220
Toronto ON M4S 1Z9
Mr. Eric K. Grossman
Lafleur Brown
Barristers and Solicitors
1First Canadian Place
Suite 920
Toronto ON M5X 1E1
Your File No. JBS-3028B
Mr. Phinh Van Pham
80 Orenda Court
Apt. # 404
Brampton ON L6W 3M9
Your File No.
Mr. George Kalopsis
Vice-President, Claims
Pafco Insurance Company Limited
1243 Islington Avenue
Suite 300
Etobicoke ON M8X 2Y3
Claim No. 4021806