Ivanovic v Allstate (Reasons for Decision)

Financial Services Commission of Ontario

FSCO A16-000346

BETWEEN

T.I. Applicant

and

ALLSTATE INSURANCE COMPANY OF CANADA Insurer

REASONS FOR DECISION

Before

Marcel D. Mongeon, Arbitrator

Heard

At Hamilton, Ontario from November 20 to 24, 2017

Appearances

Mr. T.I participated

Mr. Jonah Waxman for the Applicant

Mr. Ryan Finlay, Student-at-Law for the Applicant

Mr. Curtis Zizzo and Ms. Jasmina Mrkalj-Skelly for the Insurer

Issues

The Applicant was injured in a motor vehicle accident in January 30, 2014 and sought accident benefits from the Insurer, payable under the Schedule.¹ The parties were unable to resolve their disputes through mediation, and the Applicant, through his representative, applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c. I.8, as amended.

The issue in this Expense Hearing are

1. Did the Applicant sustain a catastrophic impairment within the meaning of the Schedule as a result of the accident?
2. Is the Applicant entitled to receive a weekly income replacement in the amount of $326.00 per week,² less amounts paid, from February 6, 2014³ to date and ongoing?
3. Is the Applicant entitled to receive a medical benefit in the amount of $5,005.46 for OT services and assistive devices, service provider Kindree OT Serivces, dated June 15, 2015?
4. Is the Applicant enetitled to attendant care benefits in the amount of$2,036.27 per month from January 30, 2014 to date and ongoing?
5. Is the Insurer liable to pay a special award because it unreasonably withheld or delayed payments to the Applicant?
6. Is the Applicant entitled to interest for the overdue payment of benefits?
7. Is the Insurer liable to pay the Applicant's expenses in respect to the arbitration?
8. Is the Applicant liable to pay the Insurer's expenses in respect of the arbitration?

Result

1. The Applicant did not suffer a catastrophic impairment as a result of the accident.
2. The Applicant is entitled to receive a weekly income replacement in the amount of $326.00 per week, less amounts paid, from February 6, 2014 to date and ongoing.
3. The Applicant is not entitled to the claimed medical benefit.
4. The Applicant is not entitled to the claimed attendant care benefits.
5. The Applicant is not entitled to a special award.
6. The Applicant is entitled to interest at the rate of 1% per month on any unpaid benefits.
7. If the parties are unable to agree on the entitlement to, or quantum of, the expenses of this matter, the parties may request and appointment with me for determination of the same in accordance with Rules 75 to 79 of the Dispute Resolution Practice Code.

 

For more details: Ivanovic v Allstate (Reasons for Decision)

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