Neutral Citation: 1996 ONICDRG 52

OIC A95-000140

ONTARIO INSURANCE COMMISSION

BETWEEN:

EDUARDO JOSE ABARCA

Applicant

and

ALLSTATE INSURANCE COMPANY OF CANADA

Insurer

REASONS FOR DECISION

Before:

Nancy Makepeace

Heard:

February 28 and 29, 1996 at the Offices of the Ontario Insurance Commission in Toronto.

Appearances:

Ian Little for Mr. Abarca

Colin Jackson for Allstate Insurance Company of Canada

Issues:

The Applicant, Eduardo Jose Abarca, was injured in a motor vehicle accident on January 29, 1994. He applied for statutory accident benefits from the Insurer, Allstate Insurance Company of Canada, payable under the Schedule.¹ The Insurer paid Other Disability Benefits of $185 a week until January 28, 1995, when benefits were terminated. The Insurer also paid the Applicants housekeeping expenses for 1994, but refused to pay further housekeeping benefits. The parties were unable to resolve their disputes through mediation and the Applicant applied for arbitration under the Insurance Act, R.S.O. 1990, c.I.8, as amended.

The issues in this hearing are:

1. Is the Applicant entitled to Other Disability Benefits, under section 19 of the Schedule, between January 28, 1995, when benefits were terminated, and June 12, 1995, when the Applicant received the report of the Designated Assessment Centre (DAC)?

2. Is the Applicant entitled to housekeeping expenses under section 55 of the Schedule?

3. Is the Insurer entitled to repayment of any housekeeping expenses overpaid, under section 70(1) of the Schedule?

4. Is the Applicant entitled to interest on overdue benefits, under section 68 of the Schedule?

5. Is the Applicant entitled to his expenses incurred in the arbitration proceeding, under section 282(11) of the Act?

6. Is the Insurer entitled to an award of $2,000 under section 282(11.2) of the Act?

Result:

1. The Applicant is entitled to Other Disability Benefits of $105.71, plus interest under section 68 of the Schedule.

2. The Applicant is not entitled to further housekeeping benefits.

3. The Insurer is entitled to repayment of housekeeping benefits overpaid in the amount of $3,600, plus interest.

4. The Applicant is not entitled to his arbitration expenses.

5. The Insurer is entitled to an award of $2,000.

Hearing:

The hearing was held in North York, Ontario, on February 28 and 29, 1996, before me, Nancy Makepeace, Arbitrator.

Present at the hearing:

Applicant:

Eduardo Jose Abarca

Applicant's

Ian Little

Representative:

Barrister and Solicitor

Insurer's

Colin Jackson

Representative:

Barrister and Solicitor

Insurer's

Kevin McConkey

Officer:

Claims Manager

Witnesses:

Mr. Abarca, the Applicant

Gilbert Barquet, Impeccably Clean, Ltd.

Deborah Meyer, Crawford & Company

Josephina Schweitzer

Soraya Jimenez

Kevin McConkey, Claims Manager, Allstate

Exhibits:

Exhibit 1

1994 housekeeping invoices (photocopies submitted to Insurer)

Exhibit 2

1995 housekeeping invoices

Exhibit 3

Applicants documents

Exhibit 4

DAC report, Dr. P. Rush, May 16, 1995

Exhibit 5

1994 housekeeping invoices (Ms. Jimenez originals)

Exhibit 6

Insurers letter (Sonia Fearon) to Applicants counsel, March 22, 1995

Exhibit 7

DAC letter to Insurer, March 30, 1995

Exhibit 8

Insurers letter (Ms. Fearon) to Applicants counsel, April 11, 1995

Exhibit 9

DAC letter to Insurer, April 18, 1995

Other Documents before the Arbitrator:

Report of Mediator, June 15, 1995

Application for Arbitration, July 24, 1995

Response to Application for Arbitration, August 29, 1995

Pre-hearing letter, December 6, 1995

Mr. Luis Alvarado, an interpreter in the Spanish and English languages, assisted the Applicant.

Other Disability Benefits:

Is the Applicant partially unable to carry on a normal life?

Under section 19 of the Schedule, the Applicant is entitled to Other Disability Benefits (ODBs) of $185 a week if he is partially or completely unable to carry on a normal life as a result of the motor vehicle accident. Section 2 defines partial inability to carry on a normal life as a substantial inability with respect to personal care, mobility or household activities, or cognitive, behavioural/emotional or communication abilities. In this case, the Applicant's claim is restricted to household activities.

The Applicant was a seatbelted passenger in a van which was struck on the passenger side while turning left on January 29, 1994. He claims that he immediately felt pain on the left side of his head, in his left arm, and in his spine. The Applicant testified that he has ongoing pain in his back and especially his left arm. He claims that he continues to be unable to carry on with his household activities because he is unable to lift anything heavy with his left hand and arm. He has been treated with medication and physiotherapy, including water therapy.

The Applicant is 55 years old. He has lived in Canada about 8 years. His wife remains in their native country. Although he has worked in construction in the past, he was unemployed for several years before the accident. He lived in a one-bedroom apartment with his eighteen-year-old son, Robert, who was then a high school student. The Applicant testified that before the accident his typical household chores included cleaning the apartment, buying groceries, cooking and doing laundry.

He claims that as a result of his injuries, he is unable to move furniture (in order to vacuum) or lift heavy things, like large amounts of laundry.

The Insurer terminated the Applicants ODBs on January 28, 1995.

I am not satisfied that the Applicant suffered a partial inability to carry on his normal life after the accident, for the following reasons.

The accident was minor. The Applicant did not go to hospital.

The Applicant gave no evidence about headaches or back problems at all, aside from stating that he complained about both to his family doctor when he first visited him after the accident. I conclude that headaches and back pain are not significant ongoing problems for the Applicant.

The Applicant testified that because of the injury to his dominant left arm, he is limited to using his right arm. However, Dr. Rush described the Applicant as right-handed, in his report of May 16, 1995. Even if the Applicant is left-handed, I am not persuaded that he is substantially disabled by left neck and shoulder problems. Susan Track, an occupational therapist who met with the Applicant at his home on October 5, 1994, reported that [d]uring the interview, the client leaned on his left elbow while sitting in the chair. Typically, if one experiences left shoulder and neck pain, one does not put weight through the arm. Ms. Track's report is consistent with my own observation of the Applicant during the hearing.

I find that the Applicant falls far short of proving that he suffered a substantial inability to carry on his pre-accident household activities. He admitted that his son helped with the housework both before and after the accident. They lived in a high-rise apartment. I heard no evidence that the Applicant performed any especially heavy or difficult housework and I heard no details about any of the household tasks the Applicant claims he performed. I do not accept the Applicant's testimony that his household chores involved 6-8 hours of work each week.

In any event, the Applicant admitted at the hearing that he has been able to vacuum, clean a small carpet, wash the dishes, clean the bathroom, do small loads of laundry and buy groceries. He also admitted that he can lift and carry light things, although he emphasized that he can only do so with his right arm. Moreover, the Applicant testified that he would be able to do some other household tasks (cooking, for example), but does not do them because the housekeeper does. On cross-examination, the Applicant admitted that the only things he could not do in 1995 were moving furniture and mopping and sweeping (which require both hands).

The only medical documentation filed in support of the Applicant's claim was the June 2, 1995 report of Dr. Gabriel Vadasz. Before the accident, the Applicant's family doctor was a Dr. Perez. The Applicant was referred to Dr. Vadasz by his lawyers. Dr. Vadasz diagnosed a left shoulder and rotator cuff strain, based on the Applicant's complaint of joint tenderness and pain. There were no neurological signs. Dr. Vadasz also diagnosed a closed head injury, myofascial strain to the cervical and lumbosacral spines, and reactive anxiety with some evidence of pain focused behaviour and somatization. Dr. Vadasz gave the Applicant's prognosis as guarded. Despite these serious problems, he did not refer the Applicant to a specialist for consultation. Dr. Vadasz opined that the Applicant remained disabled from returning to construction work; he gave no opinion as to his ability to carry on his normal pre-accident life.

I do not find Dr. Vadasz report persuasive. On October 5, 1994, the Applicant was interviewed in his home by Susan Track, an occupational therapist. Ms. Track felt that the Applicant did not seem motivated to return to his pre-accident activities. She noted that while he complained about pain, he did not exhibit any pain behaviour and he had a very functional range of motion. She did not recommend any further occupational therapy intervention.

In May 1995, the Applicant was assessed by Dr. Perry Rush, physiatrist and rheumatologist, at the Multi-Disciplinary Assessment Centre, a Designated Assessment Centre under section 63 of the Schedule. Dr. Rush found no objective evidence of clinically significant impairment. Although there was a decrease in the range of motion in the left shoulder, Dr. Rush could not determine its cause, and he did not expect it to be functionally significant.

Having heard the Applicant's evidence, I did not need to hear from the Insurer with respect to the disability issue. I do not accept that the Applicant suffered a partial inability to carry on a normal life as a result of the accident.

The Insurer's Notice of Termination:

On behalf of the Applicant, Mr. Little submitted that despite my finding on the disability issue, the Applicant is entitled to receive ODBs until June 12, 1995, pursuant to section 64 of the Schedule, the relevant parts of which are as follows:

64(1) An insurer shall not stop payment of weekly benefits under Part V on the ground that the insured person no longer suffers from a disability as a result of the accident in respect of which weekly benefits are paid, except in accordance with this section.

(2) The insurer may give notice to the insured person that the insurer will stop paying benefits on a date specified in the notice and the notice shall provide the information contained in subsections (3) to (7) and the reasons for the stoppage in payment.

(3) The insurer may stop payment of the weekly benefits on or after the date specified in the notice unless the insured person gives the insurer written notice that he or she wishes to be assessed in accordance with subsections (5) and (6).

(4) The insurer shall not specify a date for stopping payment under subsection (3) earlier than 14 days after the insured person receives the notice mentioned in subsection (2).

Subsections (5) and (6) set out a procedure for resolving disputes about choosing a DAC. Subsection (7) contains a procedure for dealing with a DAC's conflict of interest with either party.

The Insurer gave notice of termination by letter from Sonia Fearon, Senior Claims Representative, dated January 10, 1995, to the Applicant's counsel. The key paragraph is as follows:

I will be terminating the disability benefits for both Eduardo and [his brother] within 14 days based on the Independent Medical Examination results unless you dispute this cut-off date and if so, please notify me within the 14 days [sic] period so that we can arrange an assessment at the closest Designated Assessment Centre for your clients.

The Applicant concedes that the letter sets out the reasons for the Insurer's decision to terminate. The Insurer relied on the November 1994 report of Dr. R. Soric, who examined the Applicant at the Insurer's request.

The Applicant submits that the Insurer did not specify a termination date, as required by section 64(2) of the Schedule. I agree that the Insurer's notice that benefits would be terminated within 14 days of an unspecified date is not what was intended by the drafters of the Schedule. In addition, the Insurer's use of within suggests that benefits may be terminated before 14 days have passed: section 64(3) allows the Insurer to stop payment on or after the date specified in the notice and section 64(4) states that the Insurer shall not specify a date ... earlier than 14 days after the insured person receives the notice.

The termination letter is dated January 10, 1995, and does not say how much time the Insurer would allow for mail delivery. I heard no evidence as to when the letter was mailed by the Insurer or received by the Applicant's counsel. The copy of the letter filed by the Applicant is date-stamped January 18, although the second digit may have been altered. I find that the Applicant's counsel received the letter by January 18. Further to sections 64(3) and 64(4), the Applicant is entitled to ongoing benefits for 14 days following January 18 - until February 1, 1994. The Applicant also submits that the notice should have specified a date by which the Applicant had to request a DAC assessment, rather than referring again to the 14-day notice of termination. I find that the Insurer's letter is reasonably clear that benefits would be terminated in 14 days unless the Applicant requested a DAC assessment beforehand.

The Applicant also submits that the letter did not explain the provisions of section 64(5), (6) and (7) of the Schedule. I agree that the letter says nothing about the conflict of interest provisions of section 64(7). However, the Applicant does not allege that the MDA Centre had a conflict.

Nor does the letter set out the rules for choosing a DAC set out in section 64(5) and (6). However, the letter indicates that if the Applicant requests a DAC assessment, it will be arranged at the closest centre; Mr. McConkey testified that the Insurer always uses the DAC closest to the insured person, in order to prevent any dispute. The Applicant does not dispute the choice of the MDA Centre as the DAC. I find that the Applicant suffered no prejudice on account of any deficiency in this regard.

On behalf of the Applicant, Mr. Little submitted that section 64 is a mandatory provision, to which the doctrine of substantial compliance does not apply. He submitted that an insurer cannot terminate benefits unless it complies fully with the provisions of section 64. Section 64(1) states, [a]n insurer shall not stop payment of ... benefits ... except in accordance with this section. Section 64(2) provides that an insurer's notice of termination shall provide the information required [emphasis added]. I agree that the language of section 64 is mandatory. Moreover, section 64 is intended to give the insured person the option of requesting a DAC assessment if the insurer intends to terminate benefits and the insured person wishes to dispute the insurers decision. An insured person will not be able to make a timely request for a DAC assessment if he or she is not advised about the procedure. I agree that non-compliance with the notice requirements set out in section 64 may render an insurer's termination of benefits invalid.

However, I find that substantial compliance with the notice provisions of section 64 is sufficient to discharge an insurers obligations. Mr. Little conceded that the Applicant was not prejudiced by the form of the Insurer's notice. The notice was sent to Applicant's counsel, who is well-versed in the statutory accident benefits scheme. He requested a DAC assessment by letter of March 8, 1994, and the letter does not allege any defect in the Insurer's termination notice. I find that the Insurer substantially complied with the notice requirements of section 64 of the Schedule, and the Applicant, through his counsel, was aware of the procedure for requesting a DAC assessment.

The Applicant's Request for a DAC Assessment:

Although the Applicant's DAC request was not prepared until March 8, 1995, more than a month after benefits were terminated, Mr. Little submitted that upon receiving this letter, the Insurer was obliged to reinstate benefits from January 28, pending resolution of the dispute.

Subsection 64(3) provides that the insurer may stop payment of benefits on or after the date specified in the [termination] notice unless the insured person requests a DAC assessment in writing. I find this section ambiguous. It would have been an easy matter for the drafters to include the words by the date specified, so that the section read: [t]he insurer may stop payment of benefits on or after the date specified in the notice unless the insured person gives the insurer written notice by the date specified that he or she wishes to be assessed ... [emphasis added]. The omission of such words supports the Applicant's view. However, the Applicant's interpretation would leave insurers exposed to potentially large retroactive benefit payments months and years after giving notice of termination. In my view, the procedure set out in section 64 was intended to ensure fairness and finality in resolving disputes. I can think of no reason why insurers would be required to give at least 14 days notice of termination, while insured persons would be given an indefinite period in which to respond before the insurer could terminate benefits. Moreover, section 64(13) says that nothing in section 64 prevents an insured person from disputing an insurer's termination of benefits through mediation and arbitration, as happened here. The section continues:

and, if it is finally determined that payment of the benefits should not have been stopped, the insurer shall, (a) resume payment of the benefits; and (b) pay the benefits that were not paid.

Section 64(14) provides that if an insured person requests a DAC assessment but does not attend, provide reasonably necessary information, or submit to reasonable examination, the insurer may withhold benefits until the person complies, after which time the insurer shall (a) resume payment of the benefits; and (b) pay the benefits that were not paid if the assessment report determines that benefits should continue to be paid.

Considering section 64 as a whole, I find that the Insurer was not obliged to reinstate benefits on receiving the Applicant's DAC request.

Housekeeping expenses:

Between January 31 and December 31, 1994, the Insurer paid the Applicant for housekeeping services provided by Soraya Jimenez.

At the outset of the hearing, Applicant's counsel disputed whether the Insurer had paid the Applicant's October 18, 1994 claim for transportation and housekeeping expenses totalling $406., or his January 20, 1995 claim for 1994 expenses of $580. Subsequently, the Insurer satisfied the Applicant that these amounts had been paid. The Applicant claims reimbursement of further housekeeping expenses in 1995 for the services of Fidel Lopes and Rosalinda Altamirano, who were retained through Impeccably Clean Ltd. In response to the Applicant's claim for these further expenses, the Insurer raised at the pre-hearing its claim for repayment of amounts paid in 1994.

After hearing the Applicant's witnesses, I ruled that the Applicant was not entitled to housekeeping services, for the reasons set out with respect to Other Disability Benefits. The only remaining issue is whether benefits paid for housekeeping services in 1994 must be repaid to the Insurer.

The Applicant testified that in early February 1994, he asked Soraya Jimenez to provide housekeeping services for him. Ms. Jimenez lived in the same building on Lawrence Avenue, and at that time she was dating his son. The Applicant submitted monthly invoices for Ms. Jimenez' services between February and May 1994; each invoice totalled $360, billed at $7.50 an hour, for two hours a day, six days a week. Invoices were also submitted for the months June through December 1994, at reduced hours (1.5 hours a day, down from 2) bringing the monthly total to $270. The Applicant testified that Ms. Jimenez reduced her hours after May 1994 because she had moved to another building some distance away and found it less convenient to work for him.

Ms. Jimenez testified that she cleaned for the Applicant for less than two weeks, but did not continue because his apartment was clean, he was able to clean it himself and she was busy with high school. During that short period, she only worked for a little while after school, doing the dishes, for example. Ms. Jimenez testified that she signed the February invoice (two copies). She did not sign any other invoices because the Applicant didn't ask her to. Of Ms. Jimenez original invoices, only the February invoice is signed. The copies of the Applicant's originals are all signed by Soraya G. Jimenez.

A few weeks after the accident, the Applicant moved to a two-bedroom apartment on Keele Street, about five minutes from his old building by car. Ms. Jimenez testified that she never cleaned this apartment, and the first time she saw it was when she visited in the summer of 1994 and signed the invoices. Ms. Josephina Schweitzer, superintendent of the Keele Street building, testified that she has seen the Applicant bringing in groceries. She has often seen him using the building's laundry room; he has also borrowed her mop. She has never seen anyone doing housework for the Applicant. Ms. Schweitzer feels that she knows the tenants in the building and would probably ask a stranger to identify herself. The only female visitor she could recall was the Applican'ts daughter-in-law. Ms. Schweitzer denied telling the Insurer's investigator that the Applicant might have had someone helping him with his housework in the past.

I found neither the Applicant nor Ms. Jimenez to be credible witnesses. The Applicant's testimony that Ms. Jimenez provided 6-8 hours housekeeping services each week was inconsistent with Ms. Jimenez testimony and with the invoices filed by the Applicant. I heard little detail about what chores were involved. Moreover, I do not accept that someone would need 6-8 hours housekeeping assistance in a one-bedroom apartment unless they were virtually bedridden, which the Applicant was not. On the other hand, although I heard no expert handwriting evidence, I am inclined to accept that the signatures on the invoices for March through July are those of Ms. Jimenez, who admits that she signed the February invoice. (The signatures on the August through December invoices are distinctive, and may have been signed by a different person.) Ms. Jimenez' credibility is undermined by her admission that she signed the February invoice, indicating that she had done 48 hours' work, although she had not in fact worked nearly that many hours for the Applicant. When asked why she did so, she candidly answered, so I would be paid. I find it likely that when she met with the Applicant in the summer of 1994, Ms. Jimenez signed at least the six invoices for the months to date.

The Insurer paid the Applicant $3,600 for Ms. Jimenez' housekeeping services in 1994. The Applicant testified that he passed this amount on to Ms. Jimenez. However, Ms. Jimenez denied receiving any money from the Applicant. I found neither witness credible, and both have an interest in misrepresenting the events at issue. I am satisfied that the Applicant received these funds as a result of his wilful misrepresentation to the Insurer, and accordingly the money must be repaid.

Given my finding that the Applicant is not entitled to housekeeping benefits as a result of the accident, I do not need to consider the evidence as to housekeeping services provided in 1995, with one exception. The Insurer paid one invoice for $200 in January 1995, and now seeks repayment of this amount (subsequent invoices were not paid). The January invoice was rendered by Impeccably Clean Ltd., for work done by Rosalinda Altamirano. According to the Applicant, Ms. Altamirano continues to help him with his housework, although she is not being paid. Gilbert Barquet, an officer with the company, testified that invoices were prepared based on information provided by the housekeepers, and verified by telephone with the client. No further written records were kept. The two employees who might have verified this invoice are no longer with the company. Ms. Altamirano did not testify. She had not worked for Impeccably Clean before the Applicant contacted her. The Applicant testified that he knew her because she cleaned for his brother and he admitted that she is now his friend. Mr. Barquet testified that Ms. Altamirano was a friend of the Applicant before she started cleaning for him. Absent independent corroboration that Ms. Altamirano provided housekeeping services for the Applicant, I do not accept that the services were provided. I find that this invoice was paid as a result of the Applicant's wilful misrepresentation to the Insurer. Accordingly, the Applicant must repay the $200.

Expenses:

Section 282(11) of the Act gives an arbitrator discretion to award an applicant his arbitration expenses, whether or not he succeeds in the application. Arbitrators have generally awarded applicants their expenses unless the application is found to be frivolous, vexatious, or an abuse of process, or the process was unduly prolonged by the Applicant's conduct. I have no hesitation in finding that this arbitration was frivolous. There was almost no evidence in support of the Applicant's claim, and the Applicant's own testimony was not credible.

Section 282(11.2) Award:

For the same reasons, I find that the Applicant must pay the Insurer an amount equal to its arbitration fee of $2,000. On behalf of the Applicant, Mr. Little asked me to consider that the repayment issue was added by the Insurer at the pre-hearing with the Applicant's consent. I find that the Insurer was entitled to request repayment of housekeeping expenses paid, given the Applicant's application for further housekeeping expenses, because the two issues involve substantially the same evidence and enquiry. Mr. Little also suggested that the notice issue had merit. I agree that the Applicant raised legitimate questions about the requirements of section 64 of the Schedule. However, in the circumstances of this case, I find that any defect in the Insurer's notice is more than outweighed by the frivolous nature of the application.

Order:

1. The Insurer will pay the Applicant Other Disability Benefits of $105.71, with interest under section 68 of the Schedule.

2. The Applicant will pay the Insurer:

• • $3,600 (repayment of housekeeping benefits wrongfully paid to the Applicant in 1994 for the services of Ms. Jimenez);

• $200 (repayment of housekeeping benefits wrongfully paid to the Applicant in 1995 for the services of Rosalinda Altamirano);

• interest on the first two amounts, pursuant to section 70 of the Schedule; and

• the Insurer's $2,000 arbitration fee.

April 17, 1996

Nancy Makepeace Arbitrator

Date

The Applicant, Eduardo Jose Abarca, was injured in a motor vehicle accident on January 29, 1994. He applied for and received statutory accident benefits from Allstate Insurance Company of Canada ("Allstate"), payable under the Schedule.² Allstate terminated weekly income replacement benefits on __________, 199. The parties were unable to resolve their disputes through mediation, and Mr. Abarca applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c.I.8, as amended.

The issues in this hearing are:

1. Is Mr. Abarca entitled to weekly income replacement benefits from April 2, 1995?

2. What is the correct amount of the weekly income replacement benefits?

3. Is Allstate entitled to repayment of benefits already paid?

4. Is Mr. Abarca entitled to interest on any amounts owing?

5. Is Mr. Abarca entitled to his expenses incurred in this arbitration proceeding?

Result:

1. Mr. Abarca is entitled to weekly income replacement benefits from April 2, 1995.

2. The correct amount of his benefits is $500 per week.

3. Allstate is not entitled to repayment of benefits already paid.

4. The issue of expenses may now be spoken to.

EVIDENCE AND ANALYSIS:

EXPENSES:

The question of expenses was deferred until all other issues in dispute were decided. Therefore, the issue of Mr. Abarca's expenses of this arbitration proceeding may now be addressed.

April 17, 1996

Nancy Makepeace Arbitrator

Date

FSCO A95-000140

BETWEEN:

EDUARDO JOSE ABARCA

Applicant

and

ALLSTATE INSURANCE COMPANY OF CANADA

Insurer

ARBITRATION ORDER

Under section 282 of the Insurance Act, R.S.O. 1990, c.I.8, as amended, it is ordered that:

[sample orders]

1. Mr. Abarca's claim for weekly income replacement benefits is dismissed.

2. Allstate shall pay Mr. Abarca weekly income replacement benefits from April 2, 1995.

3. Mr. Abarca's weekly income replacement benefits are fixed at $500 per week.

4. The issue of expenses may now be spoken to.

April 17, 1996

Nancy Makepeace Arbitrator

Date

Footnotes

1. 1The Statutory Accident Benefits Schedule — Accidents on or after January 1, 1994, called the Schedule in this decision. The Schedule is Ontario Regulation 776/93, as amended by Ontario Regulation 635/94.
2. 2The Statutory Accident Benefits Schedule — Accidents after December 31, 1993 and before November 1, 1996, Ontario Regulation 776/93, as amended by Ontario Regulations 635/94, 781/94 and 463/96. O.R. 776/93 was extensively modified by O.R. 781/94; accordingly, where necessary, "1994 Schedule "refers to the original O.R. 776/93, and "1995 Schedule "refers to O.R. 776/93 as amended.