Abdi Malin v. State farm Mutual Automobile Insurance Company, FSCO A12-000108

CASE SUMMARY

DECISION ON EXPENSES

Abdi Malin V. State farm Mutual Automobile Insurance Company( FSCO A12-000108, July 4, 2014)

By Arbitrator:  Edward Lee

Facts

In furtherance of applicant’s (Abdi Malin) claim for accident benefits, pre- hearing was scheduled on September 10, 2013. Both the parties were present on that day and next pre- hearing was fixed for December 6, 2013. Adjudicator approved the motion filled by Mr. Malin’s former counsel to withdraw as representative on December 6, 2013. Adjudicator wrote a letter to the applicant about the new scheduled hearing on March 21, 2014 but the applicant did not respond and attend the hearing. Moreover, he failed to submit the documents. Hence, adjudicator dismissed his claim for accident benefits.

Issue-

  1. Whether or not the applicant is entitled for accident benefits?
  2. Whether or not the insurer is entitled to their expenses incurred on arbitration hearing? If “yes”, then how much they are entitled to receive?

Law –

  1. The Statutory Accident Benefits Schedule — Accidents on or after November 1, 1996, Ontario Regulation 403/96, as amended.
  2. Alfons Ranxburgaj and State Farm Mutual Automobile Insurance Company (FSCO A12-001880 , July 3, 2014)

Analysis

  1. Issue 1 –

In the present case, three pre- hearing were held and State Farm appeared before the court in all hearings scheduled but applicant failed to attend the last two. Moreover, applicant failed to provide evidence and submissions in respect of claim in the 30 days period provided by the Arbitrator. Arbitrator considered the Alfons Ranxburgaj and State Farm Mutual Automobile Insurance Company (FSCO A12-001880, July 3, 2014) where, applicant and his counsel were not present at  hearing nor provided any documents in support of accident benefit claim and the claim was dismissed by arbitrator in the end. Therefore, in present case too, arbitrator dismissed the applicant’s claim for statutory accident benefits under The Statutory Accident Benefits Schedule — Accidents on or after November 1, 1996, Ontario Regulation 403/96, as amended.

  1. Issue 2-

State farm was present at all hearings and also provided necessary documents within the period given by the arbitrator. Similarly, facts in the present case are similar to Alfons Ranxburgaj and State Farm Mutual Automobile Insurance Company, in which expenses were granted in favour of insurer. Hence,State Farm is entitled to receive expenses in regard of the time and cost spent in preparation of documents in the arbitration hearing. 

Result

Applicants claim for accident benefits dismissed and State farm is entitled to receive expense of $1,750.00.[i]

 

[i]Financial Services Commission Ontario; online:  <https://www5.fsco.gov.on.ca/ad>

Deepika Choudhary is a Paralegal student at Centennial College in Toronto studying professional communications with Omar Ha-Redeye.

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