Financial Services Commission of Ontario
Neutral Citation: 2017 ONFSCDRS 164
FSCO A14-009855
BETWEEN:
JEYANATHAN THANGARAJAH
Applicant
and
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
Insurer
REASONS FOR DECISION
Before: Arbitrator Marshall Schnapp
Heard: In person in Ottawa, Ontario on December 19 & 20, 2016, in person at ADR Chambers on January 5 & 11, 2017, and by written submissions due March 22, 2017
Appearances: Mr. Jeyanathan Thangarajah participated Mr. David S. Wilson participated for Mr. Jeyanathan Thangarajah Mr. Michael Chadwick and Mr. Stanford Cummings participated for State Farm Mutual Automobile Insurance Company
Issues:
The Applicant, Mr. Jeyanathan Thangarajah, was injured in a motor vehicle accident on September 18, 2013 and sought accident benefits from State Farm Mutual Automobile Insurance Company (“State Farm”), payable under the Schedule.1 The parties were unable to resolve their disputes through mediation, and Mr. Thangarajah, through his representative, 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:
Is Mr. Thangarajah entitled to an Order for ongoing attendant care benefits in the amount of $6,000.00 per month from September 18, 2013 to date and ongoing?
Is State Farm liable to pay a Special Award because it unreasonably withheld or delayed payments to Mr. Thangarajah?
Is either party entitled to its expenses of the Hearing?
Is Mr. Thangarajah entitled to interest for any overdue payment of benefits?
Result:
Mr. Thangarajah is entitled to an Order for ongoing attendant care benefits at $6,000.00 per month from September 18, 2013 to date and ongoing.
State Farm is liable to pay a Special Award because it unreasonably delayed payments to Mr. Thangarajah. The amount will be determined after further submissions are filed.
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 (“the Code”).
EVIDENCE AND ANALYSIS:
Background
A Pre-Hearing discussion took place in this matter before Arbitrator Reilly on May 19, 2015. At that time, the issues in dispute were identified as five medical and rehabilitation claims, an attendant care claim at a rate of $8,323.89 per month, expenses and interest.
Preliminary Motion—Special Award
At the commencement of the Hearing, the Applicant requested that the issue of a Special Award be added as an issue to the Arbitration Hearing. The Insurer’s position was that this