C.G. v. Pembridge Insurance Company (19-010979)

The claimant disputed entitlement to IRBs. The insurer raised a preliminary issue that the claimant had not applied for IRBs within the first 104 weeks following the accident and therefore could not receive IRBs. Adjudicator Johal agreed with the insurer. The claimant had not submitted a Disability Certificate within the first 104 weeks after the accident, and section 36 barred payment of any IRBs until the Disability Certificate was submitted. In order to receive IRBs, the claimant had to be receiving IRBs prior to the 104 week mark. Since his Disability Certificate was submitted after that date, he did not meet the eligibility requirements for IRBs. Adjudicator Johal rejected the claimant’s arguments that Tomec applied to the claim and that he could not have “discovered” his claim until he stopped working more than two years after the accident. The result was compelled by the IRB eligibility requirements and was not a limitations issue.