Financial Services Commission des
Commission services financiers
of Ontario de l’Ontario
Neutral Citation: 2007 ONFSCDRS 217
FSCO A06-001439
BETWEEN:
TAUSIF AHMED SIDDIQUI
Applicant
and
TTC INSURANCE COMPANY LIMITED
Insurer
REASONS FOR DECISION
Before: Fred Sampliner
Heard: October 22, 2007 at the offices of the Financial Services Commission of Ontario in Toronto
Appearances: Mr. Siddiqui was not present and no one appeared for him.
Norma Priday for TTC Insurance Company Limited
Issues:
The Applicant, Tausif Ahmed Siddiqui, was injured in a motor vehicle accident on December 5, 2005, and I issued an April 20, 2007 decision about his entitlement to statutory accident benefits from TTC Insurance Company Limited (“TTC”), payable under the Schedule.1 TTC claims that the part of the decision granting Mr. Siddiqui $380 for treatment and a $200 special award based on non-payment of the treatment is an error, and should be changed.2 The Director of Arbitrations delegated to me the authority to hear TTC’s Application for Variation (“Variation”) under Rule 63.1(c) of the Dispute Resolution Practice Code (“DRPC”) and the Insurance Act, R.S.O. 1990, c.I.8, as amended.
The issue in this hearing is:
- Should the amounts awarded to Mr. Siddiqui of $380 for treatment and $200 for a special award be changed?
Result:
- The $380 award of treatment and $200 special award are revoked.
EVIDENCE AND ANALYSIS:
The Financial Services Commission of Ontario (the “Commission”) sent copies of the Notices of the Variation Hearing (“Notices”) to the two addresses Mr. Siddiqui provided to the Commission on September 10, 2007. The Notices were not returned by postal authorities. I find that Mr. Siddiqui has been served with adequate notice of this Variation proceeding.
Mr. Siddiqui has not responded in writing to TTC’s Variation request. I held the Hearing on Variation down for 20 minutes on October 22, 2007 to await Mr. Siddiqui, but no one appeared for him.
TTC introduced documents at the Variation hearing, which contradict Mr. Siddiqui’s evidence that the 4 treatment sessions approved by the Designated Assessment Centre (“DAC”) on April 11, 2006 were not paid by the Insurer. There is no evidence from Mr. Siddiqui to contradict the TTC’s evidence on its Application for Variation of the Order.
I accept the TTC’s May 3, 2006 $380 draft for payment of the treatment recommended by the DAC and the adjuster’s letter to Mr. Siddiqui explaining this payment. This evidence establishes that all reasonable and necessary medical and rehabilitation expenses3 claimed in this proceeding were paid by the Insurer shortly after the DAC report approved them.
I find that the TTC made timely payment of the recommended treatment by the DAC, and there is no basis for the $200 special award. I further find that TTC did not unreasonably deny or delay payment of Mr. Siddiqui’s reasonable or necessary treatment expenses resulting from this accident, and that this Insurer is not liable to pay him a $200 special award under subsection 282(10) of the Insurance Act.
Pursuant to Rule 61.1(c) of the DRPC, I therefore find there are errors paragraphs number 1 and 3 of the April 20, 2007 order, and revoke those awards.
EXPENSES:
TTC did not claim its expenses of the Variation proceeding, and I accordingly make no order as to expenses.
November 8, 2007
Fred Sampliner
Arbitrator
Date
Financial Services Commission des
Commission services financiers
of Ontario de l’Ontario
Neutral Citation: 2007 ONFSCDRS 217
FSCO A06-001439
BETWEEN:
TAUSIF AHMED SIDDIQUI
Applicant
and
TTC INSURANCE COMPANY LIMITED
Insurer
ARBITRATION ORDER
Under section 282 of the Insurance Act, R.S.O. 1990, c.I.8, as amended, the April 20, 2007 decision is varied as follows:
Mr. Siddiqui is not entitled to payment for any further treatment at Victoria Park Chiropractic Rehabilitation Centre or by Dr. Samuel Cirone under Part V of the Schedule.
Mr. Siddiqui is not entitled to a special award under subsection 282(10) of the Insurance Act.
November 8, 2007
Fred Sampliner
Arbitrator
Date
Footnotes
- The Statutory Accident Benefits Schedule — Accidents on or after November 1, 1996, Ontario Regulation 403/96, as amended.
- Part V of the Dispute Resolution Practice Code (Fourth Edition – Updated October 2003)
- Part V of the Schedule