Case Summary: Hassan, Hassan and Foster and Traders

FSCO A12-006257, A12-007597 and A13-000001

FACTS OF THE CASE

Warda Hassan, Mohamud Hassan, and Anthony Foster brought a claim against Traders General Insurance Company. The applicants claimed they suffered injuries from a motor vehicle accident that took place on December 20, 2009. The three applicants applied for statutory accident benefits from the insurer. Traders General Insurance Company asserted that the applicants were not involved in any sort of accident, and thus, Traders sought a repayment of benefits. The applicants failed to participate in the pre-hearing on April 17, 2014. The mediation meeting also failed for the counsel could not get in touch with the three applicants. The applicants also made a request for arbitration. The applicants also failed to participate in the arbitration hearing on June 13, 2014.

ISSUES

The two issues outlined in the hearing are:

1) Should the applications for arbitration be dismissed?

2) Should Traders be awarded its expenses?

LAW

The applicable law in this case is the Expense Regulations made under the Insurance Act.  Specifically regulation 664 can be applied to interpret the case. Section 282 of the Insurance Act found that Traders should be awarded expenses and that the applications for arbitration be dismissed.

DECISION

1) The applications for arbitration of the three applicants are dismissed.
2) Traders General Insurance Company is entitled to the following expenses:

• $1,400.62 from Warda Hassan
• $1,151.23 from Mohamud Hassan
• $1,304.63 from Anthony Foster

REASONS AND SIGNIFICANCE OF DECISION

The applicants failed to participate at the arbitration hearing on June 13, 2014. This failure in participation leads the respondent and the Commission to believe that the applicants had deserted their claims for accident benefits. Therefore, the insurance company, Traders is awarded reasonable expenses.

Shannon O’Connor is a Paralegal student at Centennial College in Toronto studying professional communications with Omar Ha-Redeye.

Ontario Auto Insurance: A New Government Administrative Tribunal

Liberals Mandate

What the Ontario Party Platforms Say About Auto Insurance is an article addressing the Liberals rate reduction strategy for auto insurance. The Automobile Insurance Transparency and Accountability further outlines the details of the export report. The Liberals hope to decrease the rate of auto insurance by 8% as of August 2014 and 15% by August 2015.

Ontario Auto Insurance Dispute Resolution System (DRS): Cunningham’s Recommendation for a New Tribunal

Cunningham Report Recommends a New Tribunal to Deal with SABS Disputes is another article that summarizes the report. The following is outlined in the article:

• Justice Cunningham’s report included 28 recommendations to remove the system from the Financial Services Commission of Ontario (FSCO) to foster and create a new administrative tribunal
• The report suggested privatization
• The report encourages a streamlined process that ensures parties will receive an arbitrators decision within 6 months
• It will eliminate pre-hearing meetings and save time
• The new tribunal will end mediation and will be replaced with a settlement conference heard by an arbitrator
• There will be an elimination of telephone mediations and will enforce in-person arbitration and video conferencing
• An arbitrator will provide the parties with the most likely outcome if the matter does not settle
• Three arbitration streams will exist: paper reviews, expedited in-person hearings, and full in-person hearings
• New penalties will be imposed for arbitrators failing to meet deadlines
• The new tribunal will foster a cultural change

Reactions to Justice Cunningham’s Interim Report

FSCO has commented on Cunningham’s Interim Report in the following article Response by FSCO Arbitrators to Justice Cunningham’s Interim Report. The FSCO believes that the Dispute Resolution Services Branch should entail:

• Fairness, accessibility, predictability, and efficiency
• Increase the publics access to justice
• The tribunal should involve mediation and independent arbitrators
• The decision makers should be provided with tenure and financial security

The Potential Problems with Cunningham’s Report

• The process may become unfair, inefficient, and less attractive for the insured population
• Resolving disputes within 90 days is an unrealistic timeline
• Some issues are more complex
• Inadequate funding will hinder the tribunals ability to adhere to its responsibilities
• Mediation should not be eliminated for it saves time and money
• Major regulatory changes result in uncertainty, lack of predictability, and instability
• An arbitrators ability to remain neutral, independent, be an expert in the field, and hired on a full-time basis may not be attainable
• Arbitrators possibly could make decisions based on popularity rather than accuracy

Ultimately, the new tribunal should be flexible, fair, comprised of experts who are impartial decision makers.

Shannon O’Connor is a Paralegal student at Centennial College in Toronto studying professional communications with Omar Ha-Redeye.