Interim Benefits Awarded by FSCO on Basis of Financial Need

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Interim Income Replacement Benefits Awarded on Basis of Financial Hardship

Mau Bui was injured in a motor vehicle accident on January 25, 2008. He applied for and received statutory accident benefits from State Farm Mutual Automobile Insurance Company payable under the Schedule. State Farm terminated benefits. The parties were unable to resolve their disputes through mediation, and Mr. Bui applied for arbitration at the Financial Services Commission of Ontario.

Mr. Bui claimed immediate payment of the arrears, plus interest, of his income replacement benefits, together with a special award to compensate him for what he viewed as the unreasonable withholding of those benefits. He claimed entitlement due to his severely deteriorating financial situation and his family's need for support, as well as his belief in the well-founded nature of his claim.

Mr. Bui, considering that an urgent situation currently exists, and finding that his financial resources are inadequate to address his current needs, has asked that State Farm be ordered to pay arrears of benefits, ongoing benefits and interest. In essence, Mr. Bui was looking for a preliminary determination and immediate payment of his claim against State Farm.

His claim rested on his dire financial situation, the finding of a mysterious previous report by the assessor who had supported the termination of benefits that seemed to contradict his official findings, and the ultimate strength of Mr. Bui's claim for benefits.

The factors favouring an award of interim benefits in this matter are the urgency; the fact that Mr. Bui's claim appears to be well-founded and not frivolous; the length of time that has passed since payments ceased, with no alternative cash-flow source; and the fact that, on a preliminary analysis at least, Mr. Bui is likely to be successful in his claim for income replacement benefits.

In particular, Mr. Bui's financial situation was front and centre in this motion hearing. Mr. Bui produced credit card and loan statements that confirmed his dire straits. He was dependent on borrowing and gifts from family to keep from defaulting and to provide sustenance to his wife and family. Mr. Bui had no regular income stream, with the exception of his family's charity.

The Arbitrator ordered that State Farm pay an interim income replacement benefit of $185 per week, effective December 8, 2011, the date of the first pre-hearing, when this interim claim was first put forward. Payments shall be made until the final arbitration order dealing with the benefit is signed and delivered to the parties, unless otherwise varied by an arbitrator's order.

You can read the full version of this ruling of this on my website.