FSCO, Kevin Tam and Wawanesa Mutual Insurance Company

FSCO A07-002163

Kevin Tam (Applicant)
Wawanesa Mutual Insurance Company (Insurer)
July 5, 2010
Decision on Expenses

Issues:
Mr. Tam was injured in a motor vehicle accident on July, 21, 2003. He applied for SABs from Wawanesa payable under the Schedule. Issues arose between the parties concerning the Applicant's entitlement to certain SABs.
Interim decisions in this matter on January 30, 2009 and December 2, 2009. Following about 32 hours of actual hearing time, spread out over eight days, on May 20, 2010 a decision was issued that decided the Applicant's claims for statutory accident benefits. The issues in that hearing were the following:

1. Is Mr. Tam entitled to receive a non-earner benefit.
2. Is Mr.Tam entitled to receive medical and rehabilitation benefits
3. Is Mr. Tam entitled to payments for the cost of Dr. Glickman's report, Dr. Kevin Rod's report, and Dr. Dana Wilson's report.
4. Is Mr. Tam entitled to interest for the overdue payment of benefits pursuant to section 46(2) of the Schedule?
5. Is Wawabesa liable to pay a special award pursuant to subsection 282(10) of the Insurance Act because it unreasonably withheld or delayed payments to Ms. Tam?
6. Is Wawanesa liable to pay Mr. Tam's expenses in respect of the arbitration under section 282(11) of the Insurance Act, R.S.O. 1990, c. I.8?
7. Is Mr. Tam liable to pay Wawanesa's expenses in respect of the arbitration under section 282(11) of the Insurance Act, R.S.O. 1990, c. I.8?

Results:
1. Mr. Tam is not entitled to receive a non-earner benefit.
2. Of the medical/rehabilitation benefits claimed, Mr. Tam is entitled to receive $25,546.02 for the cost of prescription medication purchased from November 27, 2003 through April 2, 2007.
3. Mr. Tam is not entitled to any of the amounts he claimed under section 24 of the Schedule.
4. Mr. Tam is entitled to interest for the overdue payment of the cost of the prescripption medication set out above.
5. Wawanesa is not liable to pay a special award pursuant to subsection 282(10) of the Insurance Act.
6. The decision on expenses is deferred at the request of the parties.

The issue in this further hearing is:
1. Is either party liable to pay the other party's expenses incurred in respect of this arbitration hearing?

Result:
The Applicant shall pay to the Insurer its expenses of this proceeding related to the aborted hearing of Jan. 26, 2009, fixed in the amount of $2000.00. With respect to all other expenses related to this proceeding, the parties shall otherwise each bear their own expenses.