Financial Services Commission of Ontario
Commission des services financiers de l’Ontario
Neutral Citation: 2015 ONFSCDRS 43
Appeal P14-00029
OFFICE OF THE DIRECTOR OF ARBITRATIONS
WATERLOO INSURANCE COMPANY
Appellant
and
ASHOK SOBTI
Respondent
BEFORE:
Delegate Lawrence Blackman
REPRESENTATIVES:
Mr. Nicholaus de Koning for the Appellant, Waterloo Insurance Company
Ms. Samia M. Alam for the Respondent, Ms. Ashok Sobti
HEARING DATE:
December 19, 2014
APPEAL ORDER
Under section 283 of the Insurance Act, R.S.O. 1990, c.I.8, as amended, it is ordered that:
The Arbitrator’s June 20, 2014 decision is confirmed and this appeal is dismissed.
If the parties cannot agree on the legal expenses of this appeal, an appeal expense hearing shall be requested, as set out below, within sixty days of the date of this decision.
March 10, 2015
Lawrence Blackman Director’s Delegate
Date
REASONS FOR DECISION
I. NATURE OF THE APPEAL AND BACKGROUND
The Respondent, Ms. Ashok Sobti, was injured in a motor vehicle accident on October 1, 2008. As a result, she applied to her first-party automobile insurer, the Appellant Waterloo Insurance Company, for statutory accident benefits available under the Schedule.1 This appeal pertains to a limitation dispute under section 281.1 of the Insurance Act, R.S.O. 1990, c. I.8.
The parties agree that by covering letter and enclosed OCF-9 (Explanation of Benefits) dated December 23, 2008, the Appellant terminated the Respondent’s Attendant Care and Housekeeping and Home Maintenance Benefits. The parties further agree that the Respondent’s December 6, 2010 Application for Mediation commenced a timely mediation of these disputed benefits within the requisite two-year limitation period under the Insurance Act.
The Appellant submits that it terminated the Respondent’s Income Replacement Benefits (“IRBs”) by covering letter and enclosed OCF-9 dated March 20, 2009 sent by regular