January 31, 2005
Bogoroch & Associates represented Andrew Zaborowski, who was receiving statutory accident benefits from State Farm Mutual Automobile Insurance Company after being injured in a motor vehicle accident in May, 1998. After State Farm terminated Mr. Zaborowski’s weekly income replacement benefits, he applied for arbitration of this issue at the Financial Services Commission of Ontario under the Insurance Act.
| Before: | Fred Sampliner |
| Heard: | By telephone conference call on January 24, 2005. |
| Appearances: | Bogoroch & Associates for Mr. Zaborowski Matt Duffy for State Farm Mutual Automobile Insurance Company |
Issues
The Applicant, Andrew Zaborowski, was injured in a motor vehicle accident on May 16, 1998, and received statutory accident benefits from State Farm Mutual Automobile Insurance Company (“State Farm”), payable under the Schedule.1 State Farm terminated Mr. Zaborowski’s weekly income replacement benefits, and he applied for arbitration of this issue at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c.I.8, as amended. Mr. Zaborowski refused to attend examinations that State Farm scheduled with a physiatrist and psychologist.
The preliminary issue is:
- Is State Farm’s request that Mr. Zaborowski attend examinations with its health care experts reasonable?
- If so, what are the consequences of Mr. Zaborowski’s failure to attend?
Result
- State Farm’s examinations with its health care experts are not reasonable.
- Mr. Zaborowski’s refusal to attend has no consequence.
Notes:
1The Statutory Accident Benefits Schedule — Accidents on or after November 1, 1996, Ontario Regulation 403/96, as amended.
For the full decision, click to download: Andrew Zaborowski and State Farm Mutual Automobile Insurance Company – Decision on a Preliminary Issue