FINANCIAL SERVICES COMMISSION OF ONTARIO
Neutral Citation: 2000 ONFSCDRS 47
BETWEEN:
ALI REZA ADABI-GHOMI
Applicant
and
ALLSTATE INSURANCE COMPANY
DECISION
Before: Beth Allen
Heard: November 8, and 9, 1999 in Toronto, Ontario
Appearances:
Adam Wagman for Mr. Adabi-Ghomi
Todd J. McCarthy for Allstate Insurance Company
Issues:
The Applicant, Ali Reza Adabi-Ghomi, was injured in a motor vehicle accident on November 15, 1990. Allstate Insurance Company ("Allstate") paid him accident benefits under the Schedule.1 The issue in this case is whether Mr. Adabi-Ghomi is entitled to benefits for the rehabilitation services provided by a law clerk at his counsel's law firm.
The parties were unable to resolve their dispute through mediation and the Applicant applied for arbitration under the Insurance Act, R.S.O. 1990, c.I.8, as amended (the "Act").
The issues in this hearing are:
Is Mr. Adabi-Ghomi entitled to rehabilitation benefits for the services provided by a law clerk at his counsel's firm?
Is Mr. Adabi-Ghomi entitled to interest on overdue payments pursuant to section 68 of the Schedule?
Is Mr. Adabi-Ghomi entitled under subsection 282(11) of the Act to his expenses incurred in respect of the arbitration hearing?
Result:
Mr. Adabi-Ghomi is not entitled under section 6 of the Schedule to rehabilitation benefits for the services of the law clerk at his counsel's firm.
The issue of expenses under subsection 282(11) of the Act may now be addressed.
EVIDENCE AND ANALYSIS:
Background to the Claim:
The material facts in this case are not in dispute. Mr. Adabi-Ghomi was involved in a motor vehicle accident on November 15, 1990 when he was driving a taxi. He sustained numerous physical injuries, including a closed head injury. As a result of the accident, he has also suffered from significant psychiatric problems resulting in emotional and cognitive dysfunction. Since the accident, Allstate has funded, and continues to fund, various modes of medical and rehabilitation treatment. This treatment has included, at different times, three case managers from Rehabilitation Management Inc. (RMI), social workers, psychiatrists, treating physicians and hospital facilities. In dispute is whether Mr. Adabi-Ghomi is entitled to the cost of services provided to him by Ms. Donna Moscattini, a law clerk with the Thomson, Rogers law firm. She has been a law clerk with this firm for 12 years.
Mr. Mark Potts testified on behalf of Allstate. He has been involved with Mr. Adabi-Ghomi's case as the claims manager since the file was opened in March or April 1991. He has been in constant contact with Mr. Adabi-Ghomi and continuously consults with Ms. Moscattini, Ms. Carolyn Degenhardt, a case manager with RMI, and the other treatment providers.
Through a letter from Mr. Jim Howie, Mr. Adabi-Ghomi's legal representative, to Mr. Potts dated August 9, 1994, Mr. Adabi-Ghomi first submitted his claim for what Mr. Howie described as Ms. Moscattini's "legal/non-legal services". Later at mediation and in the Application for Arbitration, Ms. Moscattini's services were described as "supplementary case management services". There is no evidence that Allstate requested a certificate from a medical practitioner under subsection 6