FINANCIAL SERVICES COMMISSION OF ONTARIO
Neutral Citation: 2004 ONFSCDRS 126
FSCO A02-001663
BETWEEN:
FARAH MATIAS
Applicant
and
PRIMMUM INSURANCE CO. (FORMERLY CANADA LIFE CASUALTY)
Insurer
REASONS FOR DECISION
Before:
William J. Renahan
Heard:
August 16, 2004, at the offices of the Financial Services Commission of Ontario in Toronto.
Appearances:
Mrs. Matias did not appear
Jamie Pollack for Primmum Insurance Co. (formerly Canada Life Casualty)
Issues:
The Applicant, Farah Matias, was injured in a motor vehicle accident on April 30, 2002. She applied for and received statutory accident benefits from Primmum Insurance Co. (formerly Canada Life Casualty) ("Primmum"), payable under the Schedule.1 Primmum terminated weekly caregiver benefits on October 16, 2002. The parties were unable to resolve their disputes through mediation, and Mrs. Matias 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:
Is Mrs. Matias entitled to weekly caregiver benefits pursuant to section 13 of the Schedule after October 16, 2002?
Is Mrs. Matias entitled to the following costs of examinations pursuant to section 24 of the Schedule: in home assessment - $1,175; Dr. Tommy Chan - $750; and, Dr. Peer Waxer - $1,350?
Is Mrs. Matias entitled to a special award pursuant to section 282(10) of the Insurance Act?
Is either party entitled to expenses of the arbitration proceeding pursuant to section 282(11) of the Insurance Act?
Result:
The Application for Arbitration is dismissed.
Mrs. Matias shall pay Primmum's expenses of the arbitration proceedings in the amount of $5,436.59.
EVIDENCE AND ANALYSIS:
Mrs. Matias did not appear at the hearing. In the absence of any evidence, I dismiss her Application for Arbitration.
EXPENSES:
Although the arbitrator who conducted the pre-hearing in this matter did not identify expenses as an issue of the proceeding in the issues portion of his reporting letter, in a separate paragraph he advised that the hearing arbitrator could award expenses to either party and set out the criteria for such an award. Having regard to those criteria, I award Primmum its expenses of the arbitration proceeding.
I find that Mr. Pollack's claim of 50 hours preparation time for a hearing that would have lasted approximately three days is reasonable and I allow the fee he claims at the appropriate legal aid rate at $3,772.43 plus $264.07 G.S.T. His disbursements of $1,400.09 include $250 for photocopying, $100 for facsimile transmission and $600 service fees. I find the disbursements reasonable and award a total of $5,436.59.
August 30, 2004
William J. Renahan
Arbitrator
Date
Neutral Citation: 2004 ONFSCDRS 126
FSCO A02-001663
FINANCIAL SERVICES COMMISSION OF ONTARIO
BETWEEN:
FARAH MATIAS
Applicant
and
PRIMMUM INSURANCE CO. (FORMERLY CANADA LIFE CASUALTY)
Insurer
ARBITRATION ORDER
Under section 282 of the Insurance Act, R.S.O. 1990, c.I.8, as amended, it is ordered that:
The Application for Arbitration is dismissed.
Farah Matias shall pay Primmum Insurance Co. (Formerly Canada Life Casualty) $5,436.59 pursuant to section 282(11) of the Insurance Act.
August 30, 2004
William J. Renahan
Arbitrator
Date
Footnotes
- The Statutory Accident Benefits Schedule —Accidents on or after November 1, 1996, Ontario Regulation 403/96, as amended by Ontario Regulations 462/96, 505/96, 551/96, 303/98, 114/00 and 482/01.