The claimant filed a LAT Application disputing five OCF-18s for physiotherapy services, the MIG and entitlement to NEBs. The insurer requested repayment of NEBs in the amount of $6,105.00 under s. 52 of the SABS on the basis that the benefit was paid in error. The insurer argued that it erroneously paid the claimant NEBs between May 19, 2019 and January 5, 2020, and had properly requested repayment in the amount of $6,105.00, in addition to interest owing. The claimant had returned to work full-time a few days following the accident. On July 24, 2018, the insurer received an OCF-3 and requested that the claimant complete an OCF-10. On September 5, 2018, the claimant submitted a second OCF-3 supporting IRBs, but not NEBs. No OCF-10 was submitted as requested. On July 28, 2019, the claimant submitted an OCF-10 electing NEBs. In response, the insurer paid NEBs in the amount of $13,468.00. Upon review of the file, the insurer realized that the claimant was not entitlement to an NEB and requested repayment in the amount of $6,105.00, representing the amount that was paid in error over the previous 12 months. The insurer also requested an explanation in writing for the extensive delay in submitting the OCF-10. Adjudicator Corapi noted that the insurer had provided proper notice for repayment for the period stated, and had continued to follow-up with the claimant for further explanation and documentation to adjust the error, but received no response from the claimant. As the insurer’s letters and action were in compliance with s. 52, and the evidence showed that the payment was made in error, Adjudicator Corapi ordered repayment in the full amount sought of $6,105.00.
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