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An excluded driver listed on a policy is an insured person for accident benefits priority.
Matthew B, an excluded driver under his parents' Dominion policy, was injured while driving an uninsured motorcycle.
Belairdirect, insurer of the other vehicle, sought to establish priority for accident benefits.
An arbitrator found Matthew B to be an "insured person" under Dominion's policy but felt bound by a prior Superior Court decision (Dominion v. State Farm) to rule in favour of Belairdirect.
Belairdirect appealed.
The Superior Court, applying a reasonableness standard of review to the arbitrator's underlying analysis, found the arbitrator's initial conclusion that Matthew B was an "insured person" under the Dominion policy to be reasonable.
The court overturned the arbitrator's final decision, holding that Dominion has first priority to respond to Matthew B's accident benefits claim.
Judicial review Appeal dismissed
This is an appeal from an arbitration decision concerning a priority dispute between two insurers, Allstate and Intact, regarding statutory accident benefits for Ming Wu Yan.
The central issue was whether Yan was "principally dependent for financial support or care" on her daughter or son-in-law, which would make her an insured person under Allstate's policy.
The court upheld the arbitrator's finding that Yan was principally financially dependent, dismissing Allstate's appeal.
The court affirmed the arbitrator's decision not to impute monetary value to Yan's caregiving services and to exclude her foreign pension income, which was unavailable in Canada, from the dependency analysis.
The court also confirmed that the test for financial dependency requires a holistic "big picture" approach, not solely a mathematical calculation.
Insurer's method of deducting 70% of gross weekly post-accident income from IRB entitlement upheld.
The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs).
She later returned to work part-time.
The parties disputed the correct method for calculating the IRB deduction for her post-accident part-time income.
The applicant argued for an 'Equitable Approach' where her income would be prorated based on the hours she was unable to work.
The insurer argued that under section 7(3) of the Schedule, 70% of her gross weekly employment income should be deducted from her IRB entitlement.
The arbitrator agreed with the insurer, finding that the law requires the deduction to be based on the weekly income earned, not on a percentage of working versus non-working hours.
Ontario insurance contract does not establish jurisdiction over an extra-provincial defendant for an out-of-province accident.
The appellant, an Ontario resident, was injured in a motorcycle accident in British Columbia while a passenger on a motorcycle driven by an Alberta resident.
The appellant sued the driver, his insurer, and her own Ontario insurer in Ontario.
The driver successfully moved to stay the action against him for lack of jurisdiction.
On appeal, the appellant argued her Ontario insurance contract, which required her to sue her insurer in Ontario, was a presumptive connecting factor giving Ontario jurisdiction over the entire dispute.
The Court of Appeal dismissed the appeal, affirming that an insurance contract is not a presumptive connecting factor over an extra-provincial tortfeasor, and declined to apply the forum of necessity doctrine as the appellant could pursue her claim in British Columbia.
Novel jurisdiction motion justified no costs despite the moving party's success.
Following a successful jurisdiction motion, the moving defendant sought substantial costs of the Ontario proceeding.
The responding plaintiff argued that no costs should be awarded because the motion raised novel post-Van Breda jurisdiction issues intertwined with uninsured and underinsured automobile coverage provisions.
The court accepted that submission, finding the motion was reasonably brought and reasonably resisted and that the novelty and complexity of the issues made it fair for each party to bear their own costs.
No costs were awarded.
Ontario lacked jurisdiction over the out-of-province accident claim.
An Ontario resident injured as a passenger in a British Columbia motorcycle accident sued the Alberta-resident driver in Ontario and also sued her Ontario automobile insurer under uninsured and underinsured coverage.
On the driver's motion to stay for want of jurisdiction, the court held there was no real and substantial connection between Ontario and the tort claim.
The inclusion of the contractual insurance claim against the Ontario insurer did not create jurisdiction over the out-of-province tort defendant.
The forum of necessity doctrine did not apply because the plaintiff retained access to justice through proceedings in British Columbia and could still pursue insurance coverage in Ontario.
Application for arbitration filed after applicant's death was not a nullity where litigation administrator subsequently appointed.
The applicant was injured in a motor vehicle accident and subsequently died intestate.
His legal counsel filed an Application for Arbitration for statutory accident benefits after his death, without mentioning the death.
The insurer argued the application was a nullity because the lawyer's authority terminated upon the applicant's death.
The arbitrator found that because the applicant's widow was subsequently appointed as Litigation Administrator by the Superior Court of Justice specifically to continue the arbitration, the defect could be cured.
Using discretion under the Dispute Resolution Practice Code, the arbitrator ruled the application was not a nullity and allowed the arbitration to proceed.
Applicant permitted to proceed to arbitration despite late application due to reasonable explanation.
The applicant, an 18-year-old pedestrian, was struck by a bus and sustained injuries.
He applied for statutory accident benefits approximately 11 months after the accident.
The insurer denied the claim on the basis of late application without a reasonable explanation.
On a preliminary issue hearing, the arbitrator found that the applicant had a reasonable explanation for the delay, given his youth, reliance on his mother, and the time taken to identify the correct insurer.
Furthermore, the arbitrator held that the insurer failed to promptly provide the applicant with sufficient information regarding the consequences of failing to comply with the time limits, meaning the time limit to submit the application never began to run.
The applicant was permitted to proceed to arbitration.
Motion for production of lawyer's file denied as solicitor-client privilege was not waived by implication.
The insurer brought a motion for the production of correspondence and file materials between the applicant and his lawyer, arguing that the applicant had waived solicitor-client privilege by implication.
The insurer contended that the applicant placed his state of mind in issue regarding his delay in applying for statutory accident benefits.
The arbitrator dismissed the motion, finding that the applicant's conduct, rather than his state of mind or the legal advice he received, was the focus of the inquiry into whether he had a reasonable explanation for the delay.
Therefore, privilege was not waived, and the documents were protected from production.
Preliminary objections dismissed; applicant had reasonable explanation for late notice and re-election was valid.
The Applicant was injured in a motor vehicle accident during the course of his employment and initially elected to receive workers' compensation benefits.
After his condition worsened and he underwent spinal surgeries, he withdrew his election to pursue a tort claim and claim statutory accident benefits.
The Insurer raised preliminary objections that the application was out of time under subsection 32(1) of the Schedule and that the election to sue was made primarily to claim accident benefits under section 59.
The Arbitrator dismissed both objections, finding the Applicant had a reasonable explanation for the delay and that his re-election was motivated by a genuine belief he could achieve greater recovery through a tort action.