Financial Services Commission des
Commission services financiers
of Ontario de l’Ontario
Neutral Citation: 2012 ONFSCDRS 58
FSCO A11-000852
BETWEEN:
HARMEET SINGH
Applicant
and
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
Insurer
DECISION ON A PRELIMINARY ISSUE
Before: William J. Renahan
Heard: Written submissions were received at the offices of the Financial Services Commission of Ontario in Toronto up to January 6, 2012.
Appearances: Ashu Ismail for State Farm Mutual Automobile Insurance Company
Issues:
The Applicant, Harmeet Singh, was injured in a motor vehicle accident on October 3, 2006. He applied for and received statutory accident benefits from State Farm Mutual Automobile Insurance Company, payable under the Schedule.1 State Farm terminated weekly housekeeping and home maintenance benefits by “Explanation of Benefits” dated September 24, 2007. The parties were unable to resolve their dispute through mediation, and on March 18, 2011 Mr. Singh applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c. I.8, as amended.
The preliminary issue is:
- Is Mr. Singh precluded from proceeding to arbitration because his Application for Arbitration was filed beyond the two-year limitation period set out in subsection 281(5) of the Act and subsection 51(1) of the Schedule?
Result:
- Mr. Singh is precluded from proceeding to arbitration because his Application for Arbitration was filed beyond the two-year limitation period set out in subsection 281(5) of the Act and subsection 51(1) of the Schedule?
EVIDENCE AND ANALYSIS:
The Applicant did not make any submissions. I received written submissions from the Insurer.
Although the section numbers in the Act and Schedules have changed since the time of this accident, the limitation period for commencing a mediation or arbitration remains the same and that is two years from the insurer’s refusal to pay the benefit claim.
By a form “OCF-9” “Explanation of Benefits” dated September 24, 2007, State Farm advised Mr. Singh that “no further housekeeping expenses is payable beyond 5 days of this notice (10/1/07).” On that form, under the heading “Applicant’s Rights to Dispute”, State Farm advised Mr. Singh that he had two years from the insurer’s refusal to pay to apply for mediation at the Financial Services Commission and two years from the insurer’s refusal to pay to arbitrate or commence a lawsuit.
Mr. Singh applied for mediation of the housekeeping claim by Application for Mediation dated March 18, 2010. Mediation failed and he applied for arbitration by Application for Arbitration dated February 14, 2011.
The Application for Mediation and Application for Arbitration were filed more than two years after State Farm refused to pay the housekeeping benefits and are out of time.
The only substantive issue in arbitration are housekeeping benefits.
The Application for Arbitration is dismissed.
EXPENSES:
Having regard to the criteria set out in the Expense Regulation, R.R.O. 1990, Regulation 664, as amended, State Farm is entitled to its costs of this arbitration proceeding, after agreement or assessment. If the parties cannot agree on the amount, they should follow the procedure set out in Rule 79.2 of the Dispute Resolution Practice Code (Fourth Edition).
April 10, 2012
William J. Renahan Arbitrator
Date
Financial Services Commission des
Commission services financiers
of Ontario de l’Ontario
Neutral Citation: 2012 ONFSCDRS 58
FSCO A11-000852
BETWEEN:
HARMEET SINGH
Applicant
and
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
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.
Mr. Singh shall pay State Farm’s expenses of the arbitration after assessment or agreement.
April 10, 2012
William J. Renahan Arbitrator
Date
Footnotes
- The Statutory Accident Benefits Schedule - Accidents on or after November 1, 1996, Ontario Regulation 403/96, as amended.