Paul Michel Harriot and Belair Insurance Company Inc., Case Summary, FSCO# 4230

 Facts

The applicant Paul Michael Harriot injured on June 5, 2010 in a motor vehicle accident. He received statutory accident benefit from Belair insurance Company Inc. under schedule (1).[1]However, for further claims, parties were unable to resolve dispute resolution through mediation and the applicant applied for arbitration at the FSCO. In March 2013, Belair Insurance Company Inc. found evidence that the applicant was not injured in an “accident” under prescribed schedule.

Subsequently, both parties agreed for an adjournment. On April 10, 2014 pre-hearing discussion resumed but the applicant Harriot did not participate pre-hearing.  He also did not attend hearing which was held on May 20, 2014. The applicant had a burden of proof for the benefit he claimed and no supporting evidence had been provided.

 Issues

1. Whether the arbitration is dismissed due to absence of the applicant?

2. If yes, whether or not the applicant is responsible for expenses of arbitration?

Law

Under section 282 of the Insurance Act, R.S.O. 1990, c.I.8, as amended.[2]

Regulation 34/10, as amended.

Regulation: 403/96

Analysis

The applicant claimed for accident benefit and received benefit under the Statutory Accident Benefits Schedule (1). The applicant made a further claim and he had a burden of proof in support of his claim. However, the plaintiff failed to provide evidence in support of his claim. The applicant Harriot applied for arbitration but he did not participate the pre-hearing discussion as well as he did not attend the resumed hearing.

Section.51(2)[3] of O. Reg. 403/96 provides “despite subsection (1), a court proceeding or arbitration under clause 281 (1) (a) or (b) of the Insurance Act may be commenced within 90 days after the mediator reports to the parties under subsection 280 (8) of the Act or within 30 days after the person performing the evaluation provides a report to the parties under section 280.1 of the Act, whichever is later”.

The applicant or his representative was not attended the resumed dates for pre-hearing discussion or hearing. The Belair insurance company claims for arbitration expenses.

Section 282 (11) of the Insurance Act provides “the arbitrator may award, according to criteria prescribed by the regulations, to the insured person or the insurer, all or part of such expenses incurred in respect of an arbitration proceeding as may be prescribed in the regulations, to the maximum set out in the regulations 1996, c. 21, s. 38 (4)”. The Tribunal considered the amount of expenses whatever is relevant and accordingly, Belair awarded expenses $1500 (inclusive tax) for arbitration.

Conclusion

In conclusion, I would say that the applicant Mr. Harriot sustains the standard of proof. Mr. Harriot was not pursuing his claim because he did not provide evidence in support of his claim. The FSCO made a decision that the applicant was absent and did not proceed for further hearing. The arbitration is dismissed. The Belair Insurance Company Inc. awarded arbitration expenses.

 

[1]The Statutory Accident Benefits Schedule — Effective September 1, 2010, Ontario Regulation 34/10, as amended.

[2] The Insurance Act, R.S.O. 1990, c.I.8, as amended,

[3]Regulation: 403/96

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

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