Tribunal File Number: 17-000801/AABS
Case Name: 17-000801 v Economical Mutual Insurance Company
In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8., in relation to statutory accident benefits
Between:
O. D.
Applicant
and
Economical Mutual Insurance Company
Respondent
Motion Order
Order made by: Terry Hunter, Vice Chair
MOTION
- O. D. filed a Notice of Motion before the Tribunal to combine the appeal he filed (17-003489/AABS) with the appeal for the repayment of income replacement benefits filed by Economical (17-000801/AABS). The applicant also requested a resumption of the case conference.
RESULT
- The motion is denied.
BACKGROUND
O. D., was involved in motor vehicle accident on July 7, 2015 and was paid income replacement benefits by the Economical Insurance. A. D.was involved in the same accident and was also paid income replacement benefits by Economical Insurance. O. D. and A. D.are represented by the same legal counsel.
Economical Insurance filed two applications with the Tribunal for the repayment of income replacement benefits from O. D. (17-00801/AABS) and from A. D.(17-00775/AABS).
A case conference in both matters was held on May 3, 2017. In an order dated May 10, 2017, Adjudicator Chloe Lester ordered, with the consent of the parties, that both appeals would be heard together. An in-person hearing is scheduled to be held September 13 and 14, 2017.
O. D. filed an application (17-003489) with the Tribunal against Economical Insurance for the denial of income replacement benefits ongoing from 104 weeks post-accident, attendant care benefits, four treatment plans and the cost of three assessments.
O. D. filed a Notice of Motion before the Tribunal to combine the appeal he filed (17-003489/AABS) with the appeal for the repayment of income replacement benefits filed by Economical (17-00801/AABS). The same motion was filed by Arundhati Dhage.
The case conference for the appeal filed by O. D. (17-003489/AABS) is currently scheduled to proceed on August 3, 2017. A case conference for the appeal filed by A. D.(17-003911/AABS) is also scheduled to proceed on August 3, 2017
ANALYSIS AND REASONS
The applications initiated by Economical Insurance (17-000801/AABS and 17-000775/AABS) are for repayment of income replacement benefits on the basis of material misrepresentation.
Economical filed its applications for repayment on February 15, 2017.
O. D. brought a new application with the Tribunal on June 22, 2017(17-003489/AABS). A. D.filed a new application to the Tribunal on June 1, 2017 (17-003911). They now seek to combine the four files and to resume the case conference.
Economical opposes the motion arguing that the consolidation of the files would require the adjournment of the hearing scheduled for September 13 & 14, 2017. Economical argues that it has already taken steps to have witnesses summoned and incurred the costs of these steps.
There does not appear to me to be any advantage in terms of efficiency of the proceedings to be gained by consolidating the files. The issues are distinct. The appeals filed by Economical are confined to the repayment issue.
The application filed by O. D. concerns issues which issues such as entitlement to medical treatment and assessments as well as ongoing entitlement to post-104 week income replacement benefits which will require a separate evidentiary basis from that of the repayment material misrepresentation issue.
If the files are combined it would not be feasible for the hearing scheduled for September 2017 to proceed which would result in Economical losing the right to an expeditious determination of its applications.
Economical would also suffer the loss of any expenditure incurred to date for the hearing.
As I have dismissed the motion to combine the applications, resumption is not necessary and is denied.
Released: July 21, 2017
Terry Hunter, Vice Chair