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| Decision No. 707 09 IR | 15-Dec-2009 | J. Moore |
| The plaintiff brought a civil action against the defendant regarding injuries suffered in a motor vehicle accident. In Decision No. 707/09I, the Vice-Chair found that both the plaintiff and the defendant were workers in the course of employment for Schedule 1 employers at the time of the accident. In this decision, the Vice-Chair dealt with an application by the Statutory Accident Benefits insurer from whom the plaintiff received benefits. The plaintiff filed a claim for workplace insurance benefits after the accident. Upon seeking SABs, the plaintiff signed an assignment of WSIB benefits, agreeing that, if he received benefits under the WSIA, he was obligated to pay back any SABs received. Because of a dispute between the plaintiff and the insurer, the plaintiff brought another action against the insurer. The insurer now brought this application to the Tribunal for a declaration that the plaintiff’s action against the insurer was barred by the WSIA, that the plaintiff was obligated to proceed through the WSIB process and that the insurer was entitled to repayment of monies paid to the plaintiff. The Vice-Chair found that the insurer was not entitled to any of the remedies requested. There was nothing in the WSIA to prevent a worker from commencing a legal action against a private insurer. Similarly, the Tribunal does not have jurisdiction to declare that the plaintiff was obligated to proceed through the WSIB. However, the Vice-Chair did find in Decision No. 707/09I that the plaintiff’s right of action in the motor vehicle accident claim was taken away and that the plaintiff was entitled to claim workplace insurance benefits. Based on those findings, the insurer is in a position to seek appropriate remedies under the Insurance Act. The insurer was not entitled to a declaration requiring the plaintiff to repay the SABs. The assignment signed by the plaintiff was a private contract which did not fall within the jurisdiction of the Tribunal. Further, the assignment was a matter that fell within the purview of s. 30 of the WSIA, regarding which the Tribunal did not have jurisdiction. The plaintiff also was requesting reconsideration of Decision No. 707/09I. The Vice-Chair denied the application. The Vice-Chair considered the evidence and came to a reasonable conclusion. |
| View Full Decision Text 11 Page(s) |
| References: | Act Citation Other Case Reference |
| Style of Cause: | Simpson v. Barr |
| Neutral Citation: | 2009 ONWSIAT 2895 |
