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Applicant v. Aviva Insurance Canada (17-006757)

  • June 1, 2018

The insurer approved and paid NEBs and medical benefits shortly before a hearing. The claimant argued that he was still entitled to a special award. The insurer argued that the Tribunal had no jurisdiction to make the award since all benefits had been paid. Adjudicator Paluch agreed with the claimant that the Tribunal had jurisdiction to issue a special award even if no benefits remained in dispute. He concluded that the insurer had been unreasonably slow in responding to the claims for NEBs and medical benefits, and that a special award was warranted. He considered seven factors (blameworthiness of the insurer; vulnerability of the claimant; harm or potential harm directed at the claimant; need for deterrence; advantage wrongfully gained by the insurer from the misconduct; any other penalties imposed on the insurer; the overall length in delay) in concluding that an award of 40 percent was appropriate.

Full decision here

TGP Analysis

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  • FILED UNDER Special Award
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