Neutral Citation: 1996 ONICDRG 66
ONTARIO INSURANCE COMMISSION
BETWEEN:
ARNEL SAQUI
Applicant
and
ALLSTATE INSURANCE COMPANY OF CANADA
Insurer
DECISION
ISSUES:
Mr. Saqui was injured in a car accident on September 30, 1992. Before the accident he worked as a cleaner for the City of Toronto. Allstate paid him weekly income benefits of $525.61 from October 6, 1992 to May 6, 1994, when it stopped benefits on the basis that he was no longer disabled from the essential tasks of his employment. Mr. Saqui maintains that he continued to be disabled a further five months, until October 11, 1994.
Mr. Saqui's employment benefits included long-term disability (LTD) coverage with Sun Life Assurance Company (Sun Life). He did not, however, apply for LTD benefits until September 15, 1995. Although Sun Life rejected his claim, Allstate argues that LTD benefits were "available" to Mr. Saqui under subsection 12(4) of the Schedule,1 and that it is entitled to a repayment of weekly benefits equal to those amounts under subsection 27(1).
The issues in this hearing are:
Is Mr. Saqui entitled to weekly income benefits for any period between May 6, 1994 and October 11, 1994?
Is Allstate entitled to a repayment equal to the amount of LTD coverage under the Sun Life policy?
RESULT:
Mr. Saqui is not entitled to weekly income benefits beyond May 6, 1994.
Allstate is not entitled to a repayment.
Hearing:
The hearing was held in Toronto, Ontario, on November 9, 1995, before me, Deena Baltman, Arbitrator. The parties completed written submissions on December 8, 1995.
ISSUE #1: IS MR. SAQUI ENTITLED TO WEEKLY INCOME BENEFITS FOR ANY PERIOD BETWEEN MAY 6, 1994 AND OCTOBER 11, 1994?
FACTS:
Mr. Saqui is 39 years old and works as a cleaner for the City of Toronto. His job title both now and at the time of this accident is that of "General Cleaner." A general cleaner performs various cleaning duties in City-owned buildings.
Essential Tasks
The parties agreed on the essential tasks of this position, which are described in Schedule A. Briefly, a general cleaner sweeps, mops, vacuums, scrubs and spray buffs floors, hallways, and stairs. He moves furniture and equipment in order to clean floors and set up rooms. He empties wastebaskets, wipes desks and shelves, and washes marks off walls and baseboards. He cleans and disinfects washrooms and collects waste for pick-up.
During the winter, a general cleaner may be required to shovel snow, break ice and spread salt; in summer, he is required to cut grass with a push lawn mower.
These tasks require the following physical capabilities:
prolonged standing and walking
continuous reaching, stooping, twisting, pushing and pulling
lifting and carrying objects between 5-20 kg, and occasionally up to 45 kg.
climbing ladders, working overhead and handling small tools and objects.
The Accident
On September 30, 1992, Mr. Saqui was driving on the 427 highway when a van swerved into his path and struck his car on the rear of the driver's side. Mr. Saqui lost control of his car and ended up in a ditch. The police attended at the scene and Mr. Saqui was taken to the hospital, where he was examined and released. No X-rays were taken.
Injuries and Treatment
Mr. Saqui visited his family doctor, Dr. Lim, on the evening following the accident, complaining of neck and low back pain. Dr. Lim noted tenderness, spasm, and reduced range of motion, and prescribed a neck collar, medication and physiotherapy.
Mr. Saqui continued to see Dr. Lim on a weekly basis and obtained passive physiotherapy treatment from the Dornray Clinic. By March 1993, Dr. Lim concluded that Mr. Saqui needed more active exercises, and referred him to the Canadian Back Institute (C.B.I.). Mr. Saqui embarked on a comprehensive six week rehabilitation program at C.B.I. but left the program after ten days because of gastro-intestinal (GI) problems.
Dr. Allard, at Mt. Sinai hospital, arranged numerous tests to investigate Mr. Saqui's GI complaints and referred him to Dr. Diamant, a gastroenterologist. By September 1993, Dr. Allard informed Mr. Saqui that there was nothing objective to substantiate his GI complaints, and therefore no reason to refuse physiotherapy. Dr. Allard suggested a referral to the Rexdale Community Clinic (Rexdale) for a strengthening and conditioning program.
Because Mr. Saqui continued to complain of neck and back pain, Dr. Lim ordered CT scans of his neck and lower back in July and September of 1993, respectively, which were normal.In September, Dr. Lim contacted Crawford & Company (Crawford), the rehabilitation unit retained by the Insurer, regarding Mr. Saqui's status. Dr. Lim "advised there were no objective findings to support [Mr. Saqui's] complaints of pain." He agreed with Dr. Allard's recommendation to refer him to Rexdale for physiotherapy.
Despite this recommendation, Mr. Saqui refused to attend Rexdale until after he received a letter from Allstate on November 23, 1993, advising that his benefits were being terminated. He then attended Rexdale in December, where the therapist recommended: a) full active neck and back strengthening, and b) a functional conditioning program to address Mr. Saqui's work requirements.
This recommendation was delayed because Dr. Diamant, the gastroenterologist treating Mr. Saqui, referred him for an ENT assessment. This assessment was originally scheduled for February 14 but was then postponed to March 2 because Mr. Saqui had the flu. The
assessment revealed no significant abnormalities; by letter dated May 13, 1994, Crawford confirmed Dr. Diamant's telephone advice that
... Mr. Saqui has no significant abnormalities to prevent him from participating with any recommended treatment or a return to work.
...there is nothing that would limit him from resuming active therapy, in order to address functional restoration to his injuries...[emphasis added]
Allstate then arranged an IME with Dr. Ruth Smith, a physiatrist, on March 19, 1994, which Mr. Saqui failed to attend. Although he reported having difficulty finding the office, its location was clearly set out in correspondence from Crawford on March 4, 1994, and confirmed by telephone.
Allstate then arranged an IME with Dr. Peter Parker, a physiatrist, which took place on April 18, 1994. In his report of April 18, 1994, Dr. Parker concluded that Mr. Saqui had recovered from his injuries and was "capable of performing the activities of his job as a cleaner for the City of Toronto." Dr. Parker noted that Mr. Saqui had become deconditioned from inactivity but that this would not prevent him from performing his usual activities.
When Mr. Saqui learned of Dr. Parker's recommendation to the Insurer, he telephoned him and "was quite angry stating that [Dr. Parker] had said that he should go for more therapy."
Mr. Saqui threatened to both sue him and report him to the College of Physicians & Surgeons. Dr. Parker wrote a further letter to the Insurer on May 13, 1994, stating:
Although my opinion has not changed with respect to his suitability to resume his normal activities, Mr. Saqui probably will never believe that he is physically able to do this activity until he has gone through a conditioning program [such as C.B.I.]...It might help him psychologically in believing that he is now fit and able to perform his normal activites.
On the basis of Dr. Parker's findings, the Insurer ended weekly income benefits on May 6, 1994. At the same time, in compliance with Dr. Parker's recommendation, it arranged for Mr. Saqui to attend at C.B.I. in June 1994. By letter dated June 23, 1994, C.B.I, advised Allstate that Mr. Saqui had cancelled or had not shown up for three appointments. He returned to the C.B.I. in September of 1994, and underwent a six-week daily rehabilitation program. On October 11, 1994, Mr. Saqui returned to his cleaning job.
SUBMISSIONS AND FINDINGS:
Applicant's counsel submits that Mr. Saqui is entitled to weekly income benefits from May 6, 1994, when Allstate stopped benefits, to October 11, 1994, when Mr. Saqui returned to work. I find that Mr. Saqui was not disabled during that five month period, and is therefore not entitled to further benefits.
Mr. Saqui submitted little evidence in support of his claim. He was the only witness to testify at the hearing, and his complaints were scant, vague and unconvincing. Moreover, I heard virtually no evidence to corroborate his complaints of disabling pain. All the investigations performed on Mr. Saqui suggest there was no organic or objective evidence of disability during the period in question. The report of Dr. Lim, dated February 5, 1995, other than noting spasm shortly after the accident, merely documents Mr. Saqui's subjective complaints. Indeed, Dr. Lim confirms that all test results were normal and states:
His neck muscles are still sore on palpation although movements are full. He has pain on extremes. He still has tenderness in his low back and is able to bend forwards only to about 7-8 inches from the floor with his fingers down. Lateral flexion and extension are just slightly limited. He did not have any more GI complaints. [emphasis added]
The only other material from Dr. Lim is a one line letter dated July 5, 1995, in which he states "Mr. Saqui was not able to work May to October, 1994." As this statement is completely unsupported, I give it little weight.
I also find that Mr. Saqui did not take reasonable steps to advance his rehabilitation. Although he was referred to Rexdale for active physiotherapy in September 1993, he refused to attend until late November, and then only because Allstate threatened to terminate his benefits. I do not accept his explanation that his GI complaints prevented him from attending, as both Dr. Allard and Dr. Lim, who knew of his complaints, agreed that he should nonetheless pursue physiotherapy. Later on, he delayed participating in the C.B.I, program from June to September; as it was apparent by May, 1994 that there were no GI abnormalities, Mr. Saqui had no excuse for this delay.
The evidence indicates that Mr. Saqui was capable of returning to work on or before May 6, 1994, when his benefits were terminated. Although he was then still grieving his job dismissal, and therefore had no job to return to, he soon settled the grievance and was reinstated on June 27, 1994. Nonetheless, he refused to attempt a return to work until October 11, 1994. I accept that Mr. Saqui's cleaning job is physically demanding and that he was concerned about his ability to carry out his job tasks. However, both Dr. Diamant and Dr. Parker were aware of his job duties and concluded in April of 1994 that he was able to work. No reliable evidence suggests otherwise. I therefore find that Mr.Saqui is not entitled to benefits beyond May 6, 1994.
ISSUE # 2: IS ALLSTATE ENTITLED TO A REPAYMENT EQUAL TO THE AMOUNT OF LTD COVERAGE UNDER THE SUN LIFE POLICY?
FACTS:
As stated above, at the time of the accident Mr. Saqui worked as a general cleaner for the City of Toronto. His employment package included LTD coverage through Sun Life. This policy provided, after a qualifying period of six months, compensation for "total disability," defined as inability to perform "any and every duty pertaining to his normal occupation." If Mr. Saqui qualified under this definition, he would be entitled to claim income replacement payments equal to 75% of his income on the date of the accident. As Mr. Saqui's weekly wage at the time of the accident was $669.20, he was eligible to claim $501.90 per week in LTD benefits.
Mr. Saqui testified that he knew before this accident that he was entitled to LTD coverage through his employment, but understood that it would not provide income replacement until six months after an injury. Consequently, he did not make any application to Sun Life in the weeks following this accident.
Shortly after the accident, Mr. Saqui signed and submitted to Allstate an Application for Accident Benefits, dated October 12, 1992, which stated that he was not "insured under any other sick leave plan or income continuation benefit plan." He also co-signed an "Employer's Confirmation of Income" form dated October 15, 1992, which had been completed and signed by Diane Ellison, a personnel clerk with his employer. Ms. Ellison indicated that Mr. Saqui was not "eligible... under any income continuation benefit plan." Mr. Saqui submitted both forms to Allstate in support of his claim for weekly benefits.
Mr. Saqui testified that if matters had progressed in the normal course, he would have claimed LTD benefits after March 30, 1993, six months after the accident. However, in February of 1993 the City of Toronto terminated Mr. Saqui's employment, alleging that he failed to report on his progress or respond to their inquiries. Mr. Saqui stated that once terminated, he believed he lost the right to claim LTD benefits, and therefore did not submit a claim to Sun Life when the six month qualification period elapsed. He grieved the termination but was not reinstated until June 27, 1994. He returned to work on October 11, 1994.
This arbitration was originally scheduled to proceed on July 6, 1995. The Insurer discovered, only days earlier, that Mr. Saqui might be eligible for LTD. The arbitration was adjourned so that Mr. Saqui (through his counsel) could apply to Sun Life for LTD coverage for the period he was off work. Mr. Saqui's counsel contacted Sun Life regarding the claim in September 1995, but was told that Mr. Saqui was not eligible for LTD benefits because he was terminated before the date he became entitled to LTD: in an internal memo dated September 19, 1995, a representative of Sun Life confirmed a telephone conversation with Mr. Saqui's counsel, in which she advised that "'had an application been made [during the termination period], it would have been denied, as he was no longer considered an employee."2 By letter dated October 31, 1995, Sun Life formally denied the claim, on three bases:
(a) Mr. Saqui did not give adequate notice of the claim
(b) Mr. Saqui did not begin an action within the limitation period
(c) Mr. Saqui did not submit objective medical evidence to support total disability, as required by the policy.
SUBMISSIONS AND FINDINGS:
Allstate argues that after March 30, 1993, LTD benefits were "available" to Mr. Saqui under subsection 12(4) of the Schedule, which provides that an insurer may reduce a weekly benefit by any payments for loss of income "received by or available to the insured person under the laws of any jurisdiction or under any income continuation benefit plan." [emphasis added]
Allstate submits that if Mr. Saqui had submitted a proper claim in a timely matter, he would have received LTD benefits; therefore, it argues, LTD benefits were "available" to Mr. Saqui. It further maintains that if I find that LTD benefits were available to Mr. Saqui, I should order him to repay weekly benefits to Allstate in an amount equal to the LTD benefits available. Allstate submits that during the period of March 30, 1993 and May 6, 1994, Mr. Saqui was eligible for $501.90 per week in LTD benefits, totalling $29,110.21, and seeks repayment in that amount.
A. ERROR OR FRAUD
In support of its claim for repayment, Allstate refers to the provisions of subsections 27(1) and 27(3), which state:
27.-(1) A person must repay to the insurer any benefit received under this Regulation that is paid to the person through error or fraud.
(3) A person must repay to the insurer any benefit received under Sections 12 and 13 to the extent of any payments received by the person that are deductible from benefits under subsection 12(4) or 13(3). [emphasis added]
Allstate agrees that subsection 27(3) deals only with payments received by the applicant. Consequently, the Insurer cannot rely on that provision to recover collateral benefits which were "available" to but not received by Mr. Saqui. It argues, however, that subsection 27(3) does not exhaust my power to order repayment of collateral benefits, and suggests that I may rely upon subsection 27(1).
Subsection 27(1) provides for repayment where the insurer paid "any benefit" through "error or fraud." Allstate argues that it paid Mr. Saqui weekly income benefits of $525.61 in "error." It submits that Mr. Saqui knowingly submitted incorrect information to Allstate and failed to make timely application for LTD benefits. Had Allstate been aware of Mr. Saqui's entitlement to LTD benefits, it would have required him to apply for those benefits in a timely fashion and would have been entitled to deduct them from his weekly benefits.
Previous case law has considered the term "error." In Levenson,3 Arbitrator Naylor found that not any error would justify a repayment; the insurer must establish that "the actions of the Applicant, in a material way, were responsible for the overpayment.4 [emphasis added] The onus of proof is on the insurer.5 In this case, Allstate relies on three factors to support "error":
The Employer's Confirmation of Income
The Application for Benefits
Delay in applying
I will deal with each factor in turn.
1. The Employer's Confirmation of Income
Allstate submits that it was misled because Mr. Saqui co-signed and submitted an Employer's Confirmation of Income which states that he was not "insured under any other sick leave plan or income continuation benefit plan." However, I find that a close reading of the form's wording does not support Allstate's contention. The form asks "to your knowledge is Claimant eligible to receive payments under any income continuation benefit plan?" [emphasis added]. Ms. Ellison, the personnel clerk, checked off "no" as her reply. Taken literally, Ms. Ellison's response is correct: Mr. Saqui was not "eligible" to receive payments in October of 1992, when this form was completed, as the six month qualification period had not yet elapsed.
Although Ms. Ellison did not testify, I have no reason to believe that she erred in completing the form or misunderstood its questions. She filled out the two-page questionnaire in considerable detail, and gave specific answers where required. For example, where asked about the sick leave plan, she confirmed its existence and specified on which days Mr. Saqui used sick leave credits. In response to a question of whether Mr. Saqui was "entitled to receive supplementary medical, rehabilitation or care benefits under any insurance plan or law," she correctly answered "yes," and provided the insurer's name and the policy number.
Presumably, Ms. Ellison knew that LTD benefits were only available to Mr. Saqui six months after the accident. Given the ambiguous wording of the question, and its reference to the present tense ("to your knowledge is Claimant eligible..."), it is understandable, even logical, that she responded "no."
Mr. Saqui testified that he did not discuss the form or its contents with Ms. Ellison; he assumed that in her position as personnel clerk she filled it out accurately, co-signed it, and submitted it to Allstate along with his application. Even if Mr. Saqui had reviewed the employer's form, it is unlikely he would have taken issue with it: Ms. Ellison's answers were consistent with his understanding at the time he submitted the forms, which was that he was not currently entitled to benefits as the six month period had not yet elapsed. If anything, I would expect Mr. Saqui to defer to Ms. Ellison, as she worked in the personnel department and was authorized to complete and sign the form on behalf of the employer.
For these reasons I reject Allstate's submission that the Employer's Confirmation of Income shows an error attributable to Mr. Saqui.
2. The Application for Benefits
Allstate suggests that Mr. Saqui erred in submitting an Application for Benefits stating that he was "not insured under any ...income continuation benefit plan." However, there is no evidence as to who filled in the application; although Mr. Saqui acknowledged signing it, its tone and language suggest that someone else contributed to its completion. Mr. Saqui testified without an interpreter; however, he demonstrated only a basic competency with oral English. He used simple terms and gave little detail. I heard no evidence of whether he can read or write, or, if so, at what level. The Application for Benefits, on the other hand, is quite detailed and descriptive. Its sentence structure, grammar and vocabulary are inconsistent with Mr. Saqui's demonstrated English language skills. I therefore find that it is unlikely that Mr. Saqui completed the application form alone. Moreover, it is difficult to assess what, if any, contribution Mr. Saqui made to the answers contained in the form. Although he signed the form, I heard no evidence as to the surrounding circumstances, such as whether it was filled out in his presence or over the phone, or whether he reviewed the form before he signed it.
Viewed in this context, the answer regarding collateral benefits is inconclusive. Under the Section entitled "'Income from Employment, the form asks "'are you insured under any other sick leave plan or income continuation benefit plan?" [emphasis added] The answer checked off is "no." However, there is no evidence that Mr. Saqui interpreted the question correctly; he may have understood it to ask whether he is currently entitled, and not simply whether he is "insured" in the broader sense. The former interpretation is certainly consistent with Mr. Saqui's (accurate) belief that he was not then entitled to LTD benefits.
Under these circumstances, I find that at worst Mr. Saqui made an innocent but understandable error in signing the application form as it was worded. It is less easy to understand how Allstate, upon review of the application, failed to spot the possibility of this error. Allstate knew that Mr. Saqui was a salaried cleaner for the City of Toronto, a sizeable employer which one would expect to offer considerable benefits, including LTD. Allstate also had the resources and opportunity to question the accuracy of the application: Mr. Saqui promptly and freely signed an Employment Authorization which allowed Allstate access to "any information...relating to my application for income replacement accident benefits and details of any collateral sources of income or benefits." [emphasis added]
Despite this, Allstate made no inquiries until July 1995, almost three years after the accident and on the eve of arbitration.
Previous cases at the Commission have stated that the Application for Benefits is not meant to create a trap for unwary or unsophisticated applicants.6 Rather, it is "intended to provide an insurer with a starting point for its assessment of an applicant's claim".7 This is especially so where, as here, the application form on its face suggests an error which the Insurer, had it been acting prudently, could and should have investigated. Instead Allstate made no inquiries until almost three years later, and then only because of the imminent arbitration. In these circumstances I find that Allstate must share some of the failure to pursue LTD benefits and cannot, therefore, obtain repayment from Mr. Saqui solely on the basis of his error in the application.
3. Delay in Applying
Allstate criticizes Mr. Saqui because he failed to apply for LTD benefits after the six month qualifying period elapsed. However, I find Mr. Saqui's explanation plausible: when the City terminated his employment (which happened before the six month period elapsed), he assumed that he became disentitled to any employment benefits, including LTD. Therefore he did not apply to Sun Life during his termination.
Several factors support Mr. Saqui's belief that all his benefits, including LTD, ceased while he was terminated: first, he was advised by QMBA, the medical benefit carrier at work, that he was not entitled to recover medical expenses during his termination unless he took over the premium payments of $275.00 per month; second, when the City ultimately reinstated him, it was without back pay, and his record was amended to show "a leave of absence without pay for medical reasons;" third, when his counsel later approached Sun Life about LTD benefits, Sun Life advised that "had an application been made [during his termination period] it would have been denied, as he was no longer considered an employee."8
I do not agree with Allstate's suggestion that Mr. Saqui deliberately "sat on his rights" in order to prejudice Allstate. Mr. Saqui had not yet been reinstated to his job when Allstate terminated his weekly benefits in May 1994. If he believed he was entitled to LTD benefits from Sun Life, it would have been in his interest to apply for them in order to replace his income loss. He did not do so. I find that Mr. Saqui did not apply for LTD because he honestly believed he was not entitled to any job benefits while his termination was in effect, and not in order to gain any tactical advantage over Allstate.
CONCLUSION:
In this case, Allstate seeks a repayment of nearly $30,000. It bears the onus of proving that Mr. Saqui is responsible in some material way for such a significant overpayment. I am not satisfied that Mr. Saqui's conduct amounts to such an error, either in the information he supplied Allstate or in his delay in applying for LTD benefits. I therefore conclude that Allstate did not pay Mr. Saqui any benefits through "error or fraud," and is not entitled to a repayment under subsection 27(1).
My finding turns on my assessment of the facts in light of Section 27(1) of the Schedule. In the event that my assessment might be found to be erroneous, I will also consider the issue of whether LTD benefits were "available" to Mr. Saqui under subsection 12(4).
B. WERE BENEFITS "AVAILABLE"?
Allstate submits that after March 30, 1993, benefits were "'available" to Mr. Saqui under Section 12(4) of the Schedule, which provides that an insurer may reduce weekly benefits by any payments for loss of income "received by or available to the insured person under the laws of any jurisdiction or under any income continuation benefit plan." [emphasis added]
In Vo,9 Arbitrator Draper considered whether the applicant's weekly benefits should be reduced because short-term disability benefits were available to him through his employment. I agree with Arbitrator Draper's comment that
The effect of finding that payments for loss of income are available is to reduce the person's weekly income benefits...therefore, the evidence must clearly establish that the payments are, in fact, available, [emphasis added]
In this case, I am not persuaded that the Sun Life benefits are or were "in fact" available to Mr. Saqui. When contacted (in July 1995), Sun Life advised that Mr. Saqui was ineligible for LTD because he was terminated before the six month entitlement period had elapsed. Presumably its position would have been the same had Mr. Saqui inquired back in March 1993, immediately after the six month period ended and when Allstate says he should have applied. Consequently, Mr. Saqui's failure to apply any earlier is irrelevant. Even if Sun Life's position lacked merit, or would later have been reversed, its preliminary stance suggests that benefits were not clearly available.
A further complication arises because the Sun Life policy contains a different test of eligibility than that for weekly income benefits under Section 12 of the Schedule. The Sun Life policy requires the insured to prove total disability, which is defined as inability to perform "any and every duty pertaining to his normal occupation." This is, on its face, a much stricter definition than Section 12 of the Schedule, which requires "'a substantial inability to perform the essential tasks" of his employment. Counsel for Allstate submitted that the courts have liberally interpreted the definition contained in the Sun Life policy so as to conform with wording found in Section 12 of the Schedule. Although counsel cited a number of court decisions that support his position, I heard no evidence from anyone at Sun Life as to how expansively it views the definition in question. Without such evidence, I am not prepared to speculate on whether Sun Life would have granted LTD benefits if faced with the same medical information provided to Allstate.
CONCLUSION:
Allstate bears the onus of adducing clear evidence that LTD benefits were available to Mr. Saqui. Not only has it not produced any such evidence, but the only evidence before me suggests that Sun Life would have denied Mr. Saqui's claim. Moreover, the fact that a court may ultimately have compelled Sun Life to make such payments does not mean they were clearly "available" to Mr. Saqui.
I conclude, therefore, that benefits from Sun Life were not available to Mr. Saqui and, therefore, Allstate is not entitled to a repayment.
EXPENSES:
Mr. Saqui is entitled to his expenses of the arbitration under Section 282(11) of the Insurance Act, R.S.O. 1990, c.I.8, as amended.
ORDER:
Mr. Saqui is not entitled to weekly income benefits beyond May 6, 1994.
Allstate is not entitled to a repayment.
Mr. Saqui is entitled to his expenses related to the arbitration.
April 30, 1996
Deena Baltman Arbitrator
Date
Footnotes
- Prior to January 1, 1994, Ontario Regulation 672 was called the No-Fault Benefits Schedule. After that date it became the Statutory Accident Benefits Schedule - Accidents Before January 1, 1994. In this decision, the term "Schedule" will be used to refer to regulation 672.
- Exhibit 1, Page 10
- Dana B. Levenson and The General Accident Assurance Company of Canada, February 18, 1992, OIC File No. A-000260, appeal decision September 29, 1992, OIC File No. P-000260
- Supra, p. 31
- Patricia F. Main and Canadian General Insurance Company, May 6, 1994, OIC File No. A-006208
- Douglas P. Gibson and York Fire and Casualty Insurance Company, January 4, 1995, OIC File No. A-006150, page 24
- Supra, page 23
- Exhibit 1, page 10
- Chuong Vo and Maplex General Insurance Company, dated October 4, 1993, OIC File No. A002777, appeal decision March 11, 1994, OIC File No. P-002777