Claimants Need To Meet Threshold Of Due Diligence Before Applying For Benefits From Ontario’s Insurer Of Last Resort

An insurance claimant and his or her legal representative need to meet a minimal threshold of due diligence before they approach the Ontario Motor Vehicle Accident Claims Fund as a “first insurer,” a FSCO arbitrator has found.

The Motor Vehicle Accident Claims Fund acts as an insurer of last resort, paying a claim when no other insurer responsible for the claim can be identified.

In Haseeb Tariq and Motor Vehicle Accident Claims Fund, the claimant, Tariq, sustained an injury when the rented vehicle he was driving collided with the rented vehicle a friend was driving in front of him. The accident occurred on May 6, 2006.

Tariq made an application for accident benefits to the Fund on Oct. 6, 2006. In a letter to Tariq’s lawyer dated Oct. 11, 2006, the Fund said it was not able to consider the claim because Tariq was driving a rented car that was insured.

Almost two years later, the Fund received a completed application for AB benefits sent by Tariq’s lawyer. The part of the form that requests the name of the insurer was filled in with “unknown/TBD.” A police report followed the application on Dec. 19, 2008.

Explaining the lengthy delay, Tariq told the arbitrator that he was not able to get his rental car company to provide the name of its insurer. Also, he said he was not aware that it was possible to obtain a copy of the police report, which would have contained the information on insurance coverage.

“There was no explanation provided as to the reason for the two-year delay in obtaining the report,” FSCO arbitrator Elizabeth Nastasi wrote. “Further, there was no evidence presented that neither the applicant nor his counsel encountered any difficulties in requesting or obtaining the police report.

“I find that Mr. Tariq’s decision to send his completed application to the Fund was arbitrary given the limited efforts he made to determine the insurer of the rental car in this case. His efforts in attempting to obtain the name of the insurer do not meet the threshold of establishing a nexus between himself and the Fund.”