Mitra Kermani v. Wawanesa Mutual Insurance Company, 2016 ONFSCDRS 267

Financial Services Commission of Ontario

Neutral Citation: 2016 ONFSCDRS 267

FSCO A13-009440

BETWEEN:

MITRA KERMANI

Applicant

and

WAWANESA MUTUAL INSURANCE COMPANY

Insurer

REASONS FOR DECISION

Before: Arbitrator Jeff Musson

Heard: In person at ADR Chambers on July 7 & 8, 14 & 15, 2016

Appearances:

Ms. Mitra Kermani participated

Mr. Kevin D. H. Mitchell and Ms. Julianne Brimfield participated for Wawanesa Mutual Insurance Company

Issues:

The Applicant, Ms. Mitra Kermani, was injured in an accident on January 3, 2012 and sought accident benefits from Wawanesa Mutual Insurance Company ("Wawanesa"), payable under the Schedule.¹ The parties were unable to resolve their disputes through mediation, and Ms. Kermani applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c. I.8, as amended.

The issues in this Hearing are:

1. Is Ms. Kermani entitled to medical benefits in the amount of $1,177.86 pursuant to a treatment plan, dated August 10, 2012?

2. Is Ms. Kermani entitled to income replacement benefits at a rate of $400.00 per week from January 10, 2012 and on-going?

3. Is Ms. Kermani entitled to a special award?

4. Is Ms. Kermani entitled to interest for the overdue payment of benefits?

5. Is either party liable to pay expenses in respect of the Arbitration Hearing?

Result:

1. Ms. Kermani is not entitled to medical benefits and this claim is denied.

2. Ms. Kermani is not entitled to income replacement benefits and this claim is denied.

3. Ms. Kermani is not entitled to a special award.

4. Ms. Kermani is not entitled to interest for the overdue payment of benefits.

5. Wawanesa is entitled to its expenses in respect of the Arbitration Hearing. If the parties are unable to agree on the entitlement to, or quantum of, the expenses of this matter, the parties may request an appointment with me for determination of same in accordance with Rules 75 to 79 of the Dispute Resolution Practice Code.

EVIDENCE AND ANALYSIS:

Background

Ms. Kermani had legal representation at her Pre-Hearing; however, at the Hearing she decided to be self-represented. Prior to this Hearing, Arbitrator Schnapp conducted a Capacity Hearing as to the Applicant's ability to represent herself. Arbitrator Schnapp ruled that Ms. Kermani was competent to represent herself at a Hearing.

The Applicant did not call any witnesses nor was a witness list provided as per the Schedule.² Other than testifying herself, the only other witnesses who testified were all called by the Insurer.

Motions at the beginning of the Hearing

There were three Motions that were put forward at the beginning of the Hearing. One Motion was put forward by the Applicant and two