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Scarlett and Belair Appeal Allowed - Remitted to Another Hearing

The Financial Services Commission of Ontario has allowed the appeal of a previous arbitration decision with respect to the Minor Injuries Guidelines (MIG). In the appeal decision Scarlett and Belair Insurance [FSCO P13-00014] Director's Delegate David Evans allowed the appeal of the earlier decision by Arbitrator Wilson.  Our original blog post on this decision can be referenced by clicking here. Director's Delegate Evans has ordered that all issues be subject to a full hearing before another arbitrator. This appeal decision provides a few glimpses of what is likely to come from a new arbitration hearing with respect to the Minor Injury Guidelines:

  1. The dominant test of whether a person falls into the MIG is if the injury was predominantly a minor injury;
  2. The burden of proof always rests on the insured, not the insurer, of proving that he or she fits within the scope of coverage;
  3. "Compelling evidence" is more than "credible evidence"; and
  4. The MIG is binding and is not only advisory.

The Director's Delegate also noted that the arbitrator's decision breached procedural fairness by raising cases and statutory provisions of his own accord after the arbitration hearing without providing notice to the parties or an opportunity to respond.

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