June 18, 2010 by Canadian Underwriter
A claimant does not have to be found to have engaged in fraud in order for a Financial Services Commission (FSCO) arbitrator to determine that the claimant lied about being in an automobile accident.
In Azimi v Economical Mutual Insurance Company, Ashkan Azimi claimed he was injured in a car accident and applied for statutory accident benefits from Economical Mutual Insurance Company.
Economical denied the claim, arguing that Azimi was not injured as a result of an “accident” as defined in the SABS, and if an accident did occur, it was staged.
In January 2008, Azimi testified that he was driving a 2001 Honda Civic when he “t-boned” a Volkswagen Jetta.
He claimed to be driving about 60 km-h in wet road conditions when the incident occurred.
When police arrived at the scene, the vehicles were sitting in the intersection, resting perpendicular to one another, with the Honda’s front end pressed into the VW’s driver side.
A police report, as well as two forensic investigation reports, noted that had Azimi broad-sided the VW at 60 km-h, both vehicles would have spun and would not be resting in the ‘T’ position. Also, all three investigators found the damages to both vehicles were inconsistent with such an accident. They commented that the damage to both cars appeared to have happened in earlier incidents.
A claims history search of the Honda found that it had been involved in two prior accidents and had been labelled as salvage some three months before Azimi purchased it. Azimi purchased it just six days before the alleged accident. The VW had been insured days before the accident as well, and that insurance policy was only for 30 days, FSCO arbitrator Jessica Kowalski wrote.
“I agree with Economical that I do not have to find that Mr. Azimi engaged in a fraud in order to find that he was not involved in an “accident” as defined by subsection 2(1) of the Schedule,” Kowalski wrote.
“While I certainly have insufficient evidence to find fraud on the part of Mr. Azimi, I am not satisfied that an “accident” occurred as Mr. Azimi has alleged.”
Kowalski recommended that parties resolve the issue of expenses between themselves, since neither made submissions with respect to expenses.