Financial Services Commission des
Commission services financiers
of Ontario de l’Ontario
Neutral Citation: 2012 ONFSCDRS 64
FSCO A10-003589
BETWEEN:
SAROSH ALTAF
Applicant
and
ECONOMICAL MUTUAL INSURANCE COMPANY
Insurer
REASONS FOR DECISION
Before: Lloyd (J. R.) Richards
Heard: February 24, 2012, at the offices of the Financial Services Commission of Ontario in Toronto
Appearances: No one appearing for Mrs. Altaf
Heather Geertsma for Economical Mutual Insurance Company
Issues:
The Applicant, Sarosh Altaf, was injured in a motor vehicle accident on January 28, 2009. She applied for and received statutory accident benefits from Economical Mutual Insurance Company (“Economical”), payable under the Schedule.1 Economical denied Mrs. Altaf’s claims for the following benefits:
Caregiver benefits at the rate of $250.00 per week from May 28, 2009 to date and ongoing.
Medical benefits in the amount of $1724.44 for services by We Do Care, under a treatment plan dated April 3, 2010.
Medical benefits in the amount of $9877.30 for services by Global Rehabilitation.
Housekeeping and home maintenance benefits in the amount of $7500.00 from June 9, 2009 to date and ongoing.
Cost of assessments in the amount of $325.00 for a rebuttal report by OSAC, dated June 26, 2009.
Mrs. Altaf claims entitlement to interest for the overdue payment of benefits.
Mrs. Altaf and Economical both claim entitlement to their expenses in respect of the arbitration.
The parties were unable to resolve their disputes through mediation, and Mrs. Altaf applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c.I.8, as amended.
Neither Mrs. Altaf, nor anyone representing her, appeared at the Commission on the hearing date of February 24, 2012.
Result:
Mrs. Altaf’s claims are dismissed.
Mrs. Altaf is liable to pay Economical’s expenses in this matter in the amount of $1000.00.
EVIDENCE AND ANALYSIS:
The onus is on Mrs. Altaf to prove her claims on a balance of probabilities, and she has not met that onus. Mrs. Altaf has been given proper Notice of this hearing, as well as an opportunity at a pre-hearing, to appear before this Commission to advance her case.
I conducted the first pre-hearing in this matter on December 19, 2011 and Mrs. Altaf did not attend. Prior to the pre-hearing, Mrs. Altaf’s representative, Mr. Mario Glykis of Pace Law Firm, sent correspondence to the Commission requesting permission to withdraw. With no one at the pre-hearing representing Mrs. Altaf’s interests, I declined her representative’s request and instead set a hearing date in this case, at which time I would consider his request to withdraw.
The Commission sent Notice of this hearing to Mrs. Altaf’s last known address. Notes in Mrs. Altaf’s Commission file indicate that case administrators persistently attempted to contact her by telephone without success. At this hearing, Mr. Glykis provided documents showing that he had attempted to contact Mrs. Altaf on September 21, 2011, September 29, 2011 and December 19, 2011 without success. Mr. Glykis alleged that there had been a breakdown in the relationship with his client as he had been unable to get instructions from her. Pursuant to Rule 9.8 of the Dispute Resolution Practice Code, I order that Pace Law Firm be permitted to withdraw as Mrs. Altaf’s representative.
After dealing with Pace Law Firm’s request to withdraw, I adjourned the hearing for thirty minutes, giving Mrs. Altaf an opportunity to appear. As Mrs. Altaf did not appear after the thirty minute adjournment, the hearing in this matter proceeded in her absence. Hearing no evidence from Mrs. Altaf, and hearing nothing from Economical in the way of evidence that could support Mrs. Altaf’s claims, I find that she has failed to meet the burden of proving her claims. Therefore, her claims for benefits are dismissed.
EXPENSES:
Economical submitted that it had worked approximately 17 to 18 hours on defending Mrs. Altaf’s claims, with lead counsel working 10 hours and a clerk working between 7 to 8 hours. In addition, Economical appeared twice at the Commission to address Mrs. Altaf’s claims. Economical claimed $1000.00 in expenses.
Rather than going through a line by line analysis of Economical’s expense claims in this matter, I find that $1000.00 reflects a reasonable amount of expenses in this arbitration. I therefore fix Economical’s expenses in the amount of $1000.00.
April 19, 2012
J.R. Richards
Arbitrator
Date
Financial Services Commission des
Commission services financiers
of Ontario de l’Ontario
Neutral Citation: 2012 ONFSCDRS 64
FSCO A10-003589
BETWEEN:
SAROSH ALTAF
Applicant
and
ECONOMICAL MUTUAL 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:
Mrs. Altaf’s claims for benefits are dismissed.
Mrs. Altaf is liable to pay Economical’s expenses in the amount of $1,000.00.
April 19, 2012
J.R. Richards
Arbitrator
Date
Footnotes
- The Statutory Accident Benefits Schedule — Accidents on or after November 1, 1996, Ontario Regulation 403/96, as amended.