Yousaf Safi v. Sovereign General Insurance Company, 2008 ONFSCDRS 91

Financial Services Commission des

Commission services financiers

of Ontario de l’Ontario

Neutral Citation: 2008 ONFSCDRS 91

FSCO A04-001121

BETWEEN:

YOUSAF SAFI

Applicant

and

SOVEREIGN GENERAL INSURANCE COMPANY

Insurer

DECISION ON

SPECIAL AWARD AMOUNT

Before: Edward Lee

Heard: By telephone conference call on April 4, 2008

Written submissions were received on April 18, 2008

Appearances: Jeffrey Raphael for Mr. Safi

Barbara MacFarlane for Sovereign General Insurance Company

Issues:

A decision was rendered in this matter on January 23, 2008.¹ After the issuance of that decision, the parties requested a clarification of part of that order. The parties were also invited to provide submissions in regard to the amount of the special award to be made.

In regard to the request for clarification, I find that my order was clear and unambiguous. As stated in my arbitration order at paragraph 2, Sovereign General Insurance Company is required to pay Mr. Safi the amounts of $1,920.00, $1,290.00, $1,540.00, and $4,500.00 with interest.

SPECIAL AWARD:

I heard submissions from the parties in regard to the amount of the special award. I have already issued reasons for making that special award in my previous decision. I determined that the Insurer had acted imprudently in denying two treatment plans (total value $3,210.00), and then unreasonably withheld or denied their payment. In this case, I find that the gravity of misconduct by the Insurer warrants the making of a modest special award. Having regard to the criterion and approach set out in the Liberty Mutual Insurance Company and Persofsky² appeal decision, and having determined the maximum award possible, I am convinced that the appropriate special award amount in these circumstances is $3,500.00.

June 12, 2008

Edward Lee

Arbitrator

Date