Category: Late Application

The claimant applied to the LAT seeking entitlement to accident benefits. He was involved in a motor vehicle accident as a pedestrian. The main issue was whether the claimant was barred from proceeding to a hearing as he failed to notify the insurer of the circumstances giving rise to a claim for benefits no later than the seventh day after the circumstances arose, or as soon as practicable after that day, as required by section 32(1) of the Schedule. Adjudicator Kaur found that the claimant was not statute-barred from proceeding with his claim. This decision was based on the evidence supporting that the claimant was an unsophisticated party, who may not realize that one can apply for accident benefits through their insurer in circumstances where they were hit as a pedestrian. The claimant had a limited level of education and worked as a labourer/landscaper. Adjudicator Kaur concluded that it would be equitable to relieve against the consequences of the claimant’s failure to comply with s. 32 as he provided a reasonable explanation for the delay.

This is a preliminary decision regarding late notice to the insurer. The claimant applied for Accident Benefits 20 years after the accident. In addition, the claimant’s insurance expired before the accident. Before October 1, 2003, S. 32(1) of the SABS provided that the insured must advise the insurer of an intention to claim benefits within 30 days of the loss date. The claimant did not notify the insurer according to S. 32(1)(a). As well the claimant was found to have failed to submit the OCF-1 within 30 days. The claimant did not provide a reasonable explanation for the delay. The claimant was barred from proceeding with LAT application.

This is a preliminary decision regarding late notice to the insurer. The claimant applied for accident benefits one year after the accident. The claimant’s explanation for the delay was that she had retained counsel after the accident and did not know the process for claiming benefits. The Adjudicator found that reliance on the solicitor was not a reasonable excuse for the claimant’s delay. The claimant’s LAT application was dismissed.

This is a preliminary decision regarding late notice to the insurer. The claimant applied for accident benefits two years after the accident. Section 32(1) of the SABS provides that the insured must give notice of the intention to claim benefits within 7 days of the loss date. The claimant conceded that they were two years late but argued that they had a reasonable explanation under s. 34 of the SABS. The claimant explained that since their impairment stemmed from two accidents, and as time progressed they learned that their impairment was caused by the subject accident. The claimant did not provide any substantive evidence for their impairment. The insurer was not required to send an OCF-1 as it did not know about the accident. The Adjudicator found that the claimant failed to provide a reasonable explanation for failure to comply with timelines under the SABS. The LAT application was dismissed.