Appanah v. Belair Insurance Company Inc., 2014 ONFSCDRS 114

Financial Services Commission des Commission services financiers of Ontario de l’Ontario

Neutral Citation: 2014 ONFSCDRS 114

FSCO A12-002074

BETWEEN:

JOHNNY AVINASH APPANAH

Applicant

and

BELAIR INSURANCE COMPANY INC.

Insurer

REASONS FOR DECISION

Before: Arbitrator Jeffrey Rogers

Heard: May 20, 2014, at the offices of the Financial Services Commission of Ontario in Toronto.

Appearances: Mr. Andrew McKague, solicitor for Belair Insurance Company Inc. No one appearing for Mr. Appanah

The issues in this hearing are:

Should this arbitration be dismissed because Mr. Appanah has failed to participate?
Is Mr. Appanah liable to pay Belair’s expenses of the arbitration, and if so, in what amount?

Result:

This arbitration is dismissed.
Mr. Appanah shall pay Belair’s expenses of the arbitration in the amount of $1,500.

EVIDENCE AND ANALYSIS:

The Applicant, Johnny Avinash Appanah, alleges that he was injured in a motor vehicle accident on June 5, 2010. He applied for and received statutory accident benefits from Belair Insurance Company Inc. (“Belair”), payable under the Schedule.¹ Disputes arose regarding his entitlement to further claimed benefits. The parties were unable to resolve their disputes through mediation, and Mr. Appanah applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c.I.8, as amended.

In March 2013, Belair received evidence that Mr. Appanah was not injured in an “accident” as defined in the Schedule. A pre-hearing discussion was held on June 17, 2013. Mr. Appanah’s representative attended. Mr. Appanah did not attend. The pre-hearing Arbitrator proceeded with the pre-hearing and scheduled a hearing, to start on May 20, 2014. The issues in dispute were identified as medical benefits, attendant care benefits, housekeeping and home maintenance benefits, and the cost of assessments or examinations.

There was a subsequent breakdown in the relationship between Mr. Appanah and his representative. On those grounds, an order was made removing the representative from the record. The pre-hearing discussion was resumed on April 10, 2014 in order to ascertain whether Mr. Appanah intended to pursue this arbitration. He was given notice of the resumption at his last known address in the records of the Commission. He did not participate in the resumed pre-hearing.

Mr. Appanah did not attend the hearing on May 20, 2014. I am satisfied that he was given notice of the hearing at his last known address in the records of the Commission. There is nothing to suggest that the hearing should not proceed. Mr. Appanah bears the onus of proving entitlement to the benefits he claimed. No evidence having been tendered in support of the claims, this arbitration is dismissed.

EXPENSES:

Belair claimed its expenses of the arbitration in the amount of $1,500, inclusive of disbursements and HST. I find that Belair is entitled to expenses, based on its success. I find the amount claimed to be reasonable, given the number of attendances by counsel and the cost of investigating the alleged “accident”.

July 8, 2014

Jeffrey Rogers Arbitrator

Date