More Clarification on the Meaning of “Economic Loss”

January 17, 2013 | Talaal Bond

In the recent case of Simser and AVIVA (FSCO A11-004610, January 16, 2013), Arbitrator Lee was tasked with examining the meaning of “economic loss” as per s. 3(7)(e) of the Statutory Accident Benefits Schedule.

The insured sought to have expert opinion evidence accepted regarding the definition of  “economic loss”. He argued that since it was not defined in the SABS it should be defined to include “opportunity cost”, as well as loss of time devoted to labour or leisure. However, the arbitrator noted that this interpretation would result in every provider meeting this requirement, negating the meaning of the amendment. The insured’s argument was rejected.

The application of the plain meaning of “economic loss” led to the conclusion that no economic loss was sustained and as such the claimed benefits were rejected. The insured had applied for attendant care and housekeeping benefits following his accident of November 10, 2010.   None of the providers tendered supporting documentation to that would have demonstrated an actual loss. The only witness was found not to be credible due to the “glaring lacunae” in her evidence. Accordingly, no amounts for benefits claimed in the arbitration proceeding were payable.

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