Bianca v. Wawanesa Mutual Insurance Company – Decision on a Preliminary Issue

November 30, 2004

Bogoroch & Associates represented Mrs. Coradina Bianca, who applied for statutory accident benefits from Wawanesa after a motor vehicle accident in 2001. When Wawanesa indicated that they would not accept the claim, Mrs. Bianca applied for arbitration at the Financial Services Commission of Ontario (FSCO) under the Insurance Act. The FSCO determined that Wawanesa is required to respond to Mrs. Bianca’s claim for statutory accident benefits.

Issues

The Applicant, Coradina Bianca, was injured in a motor vehicle accident on January 25, 2001. She applied for statutory accident benefits from Wawanesa Mutual Insurance Company (“Wawanesa”), payable under the Schedule.1 Wawanesa returned the application to Mrs. Bianca, saying it would not accept the claim. The parties were unable to resolve their disputes through mediation, and Mrs. Bianca applied for arbitration at the Financial Services Commission of Ontario under theInsurance Act, R.S.O. 1990, c.I.8, as amended.

The preliminary issue is: "Is Wawanesa required to respond to the Applicant’s claim for statutory accident benefits?"

Result

"Wawanesa is required to respond to Mrs. Bianca’s claim for statutory accident benefits."

Evidence and Analysis

This application for benefits has a rather complex history. However, the relevant facts are agreed between the parties, with one exception.

Mrs. Bianca was walking across Danforth Avenue in Toronto on January 25, 2001, when she was knocked down by a 1987 Dodge van owned by a man named Vito Morelli and driven by a woman named Wilma Little. Mrs. Bianca was not an insured person under any auto insurance policy. The van that hit her was not insured at the time of the accident. The driver, Ms. Little, had had insurance with Wawanesa covering other vehicles. The one fact in dispute is whether Ms. Little had any liability insurance in effect with Wawanesa at the time of the accident. Wawanesa asserts there was no liability insurance in place (which would include statutory accident benefits). Mrs. Bianca argues there was.

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: Bianca and Wawanesa Mutual Insurance Company – Decision on a Preliminary Issue