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Certas Direct Insurance Company v. K.P. (18-005710)

  • July 2, 2019

The insurer sought repayment of IRBs alleging that the claimant had misrepresented his work status for a period of seven months. Adjudicator Parish accepted that the claimant was working during the seven month period he was receiving IRBs, and that the claimant wilfully misrepresented his work status in signing an OCF-13 which stated he had not earned any income, as well as stating the same during an examination under oath. The adjudicator also held that the insurer had requested repayment in accordance with section 52. Because the claimant committed a material misrepresentation, the 12 month time limit on the repayment request did not apply.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Repayment
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