Financial Services Commission
Commission des services financiers de l’Ontario
Neutral Citation: 2002 ONFSCDRS 52
Appeal P01-00018
OFFICE OF THE DIRECTOR OF ARBITRATIONS
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
Appellant
and
EVAN GRIFFITHS
Respondent
Before:
David R. Draper, Director of Arbitrations
Counsel:
Joseph J. Sullivan (for State Farm)
Paul Barrafato (for Evan Griffiths)
APPEAL ORDER*
Under section 283 of the Insurance Act, R.S.O. 1990, c.I.8, as amended, it is ordered that:
- The appeal is allowed. The arbitration order dated March 28, 2001, is rescinded and replaced with the following:
Evan Griffiths is not entitled to Ontario statutory accident benefits from State Farm Mutual Automobile Insurance Company.
- The parties will bear their own appeal expenses.
March 25, 2002
David R. Draper Director of Arbitrations
Date
REASONS FOR DECISION
I. NATURE OF THE APPEAL
This appeal involves the scope of coverage provided to non-residents under the standard Ontario motor vehicle liability policy in use in 1990 (OPF 1). Evan Griffiths, a resident of Colorado, was injured in an accident in New York State while a passenger in a car driven by his friend, Ralph Packer. Mr. Griffiths did not have his own automobile insurance. Mr. Packer, an Ontario resident, insured his car through an Ontario policy issued by State Farm Mutual Automobile Insurance Company (State Farm).
State Farm accepts that as an insurer authorized to conduct business in New York, it was required by New York law to pay Mr. Griffiths the first-party benefits mandated in that State, which it did. The question is whether he is entitled to the more generous Ontario benefits. On appeal, State Farm challenges the arbitrator's conclusion that Mr. Griffiths qualifies as an "insured person" under Mr. Packer's policy and, therefore, is entitled to Ontario benefits.
II. BACKGROUND
The arbitration proceeded on an agreed statement of facts. For convenience, I will reproduce the relevant paragraphs here, omitting the medical evidence:
Evan Griffiths was a passenger in a vehicle driven by Ralph Packer when it was involved in an automobile accident in 1990 in New York State.
The Packer vehicle was insured by State Farm under an Ontario policy issued by State Farm in Markham, Ontario.
Evan Griffiths was a resident of Colorado who was visiting his friend, Ralph Packer, in Ontario when they decided to go to New York State. Evan Griffiths was not living nor ordinarily present in Ontario.
Evan Griffiths did not own a vehicle nor was a named insured on any other automobile insurance policy nor was a spouse or dependant of any other named insured under any other automobile insurance policy.
State Farm paid Evan Griffiths a total of US $20,992.50 in New York State no-fault benefits.
The key section in the New York legislation is s. 5107(a) of the New York Insurance Law, which states as follows:
Every Insurer authorized to transact or transacting business