Steve B. Macaulay

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits from Wawanesa, who denied coverage alleging the policy was void due to misrepresentation and had been terminated prior to the accident.

The applicant then applied to Guarantee, the insurer of the other vehicle, who argued Wawanesa was responsible.

The arbitrator held that Ontario Regulation 283/95 did not apply retroactively to this dispute.

The arbitrator further found that Wawanesa failed to properly terminate the policy because the premium refund did not accompany the notice of termination as required by statutory condition 12 of the Insurance Act.

Additionally, the applicant's misrepresentations did not render the policy void ab initio for the purpose of statutory accident benefits.

Wawanesa was ordered to pay the benefits.

The applicant was involved in a motor vehicle accident and applied for income replacement benefits, which the insurer denied.

The applicant applied for arbitration more than two years after the insurer's clear and unequivocal written denial.

The arbitrator held that under section 281(5) of the Insurance Act, the two-year limitation period begins to run from the date of the insurer's refusal to pay, not on a rolling basis as under previous legislation.

Consequently, the applicant was precluded from proceeding to arbitration.