REASONS FOR DECISION AND ORDER ON A PRELIMINARY ISSUE
Tribunal File Number: 16-000024/AABS
Case Name: 16-000024 v Economical Mutual Insurance Company
In the matter of an Application for Dispute Resolution pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8., in relation to statutory accident benefits.
Between:
B. C.
Applicant
and
Economical Mutual Insurance Company
Respondent
Adjudicator: D. Gregory Flude, Vice-Chair
Observers: Chloe Lester, Jeanie Theoharis, and Joseph Nemet, Members
Appearances:
For the Applicant: Frank Van Dyke, counsel for the Applicant
For the Insurance Company: Jody Gleeson, Adjuster
Held by Teleconference : June 1, 2016
Overview:
1The applicant was injured in a motor vehicle accident on November 12, 2015. He applied to Economical Mutual Insurance Company (the Insurance Company) for an Income Replacement Benefit (IRB) pursuant to Ontario’s no-fault insurance scheme. The Insurance Company denied his claim because his licence was invalid on the day of the accident. The applicant appeals that denial to this Tribunal. For reasons more fully set out below, the Tribunal finds that the applicant is not entitled to an IRB, and his Application is dismissed.
Analysis:
2In its response to the Application, the Insurance Company raised the applicant’s invalid licence as a complete response to the appeal. The Tribunal asked the parties to make written submissions in advance of the pre-hearing and advised them that it would hear oral submissions and decide the issue at the Case Conference.
3The applicant’s entitlement to no-fault benefits is governed by the Statutory Accident Benefits Schedule – Effective September 1, 2010 (the ‘SABS’)1. Part II sets out the entitlement to an IRB, but that entitlement is subject to the exclusions in section 31(1). Subsection 31(1)(a)(ii) denies the right to claim IRB to persons who were driving without a valid driver’s licence at the time of the accident.
4It is not disputed that the applicant was driving without a valid driver’s licence at the time of the accident. He was charged at the scene by Constable Huygen of the Cornwall Police Service. The applicant acknowledged in an email to Constable Huygen dated November 13, 2015 that his licence had expired prior to the date of the accident.
5The applicant asserts that he was unaware that his licence had expired. In the November 13, 2015 email to Constable Huygens, the applicant explained that he did not receive a notice of renewal from the Ministry of Transportation. He acknowledges receiving a notice to renew his vehicle registration stickers, but nothing concerning the renewal of his driver’s licence. The applicant asserts that his lack of knowledge that his licence had expired relieves him from the application of subsection 31(1)(a)(ii) of the SABS. The Tribunal disagrees.
6The starting point for the interpretation of statutory language is to consider the plain meaning of the words of the section within the legislative context. If there appears to be ambiguity in the wording, the Tribunal may consider other sources. The Tribunal can find no ambiguity in the wording addressing the consequences of being the driver of vehicle involved in an accident while holding an expired licence. It unambiguously excludes a driver’s right to IRB, stating that :
“the insurer is not required to pay an income replacement benefit, … if the driver was driving the automobile without a valid driver’s licence.”
7The Tribunal finds support for its interpretation of the legislation when considering the balance of subsection 31 (1)(a). Of the four exclusions of entitlement to an IRB, two include a mental element, with the words “the driver knew or ought reasonably to have known.” They contemplate situations when a driver may not be aware that there was no insurance or aware that the vehicle was being operated without the owner’s consent. It is clear when considering these exclusions that the Legislature turned its mind to the issue of the driver’s knowledge or intent and chose not to include it in the case of drivers operating with an invalid licence. To the extent that the applicant asks the Tribunal to import the requirement of “knew or ought reasonably to have known” into the provision dealing with a lack of a valid licence, given the clear language of the legislation, the Tribunal declines to do so.
8The Tribunal finds that for the Insurance Company to bring itself within the exclusion of s. 32(1)(a)(ii) it is sufficient for it to prove that, at the time of the accident, the driver of the automobile did not hold a valid driver’s licence. It is immaterial whether it was suspended, expired, or was of the wrong class for the type of vehicle being operated. In this case, it is not disputed that the applicant’s licence had expired. The Insurance Company has satisfied its onus.
Order
9Having read the evidence and having heard the submissions of the parties, the Tribunal orders that this application is dismissed.
Date of Issue: July 5, 2016
D. Gregory Flude, Vice-Chair