M.R. v. Aviva Insurance Company of Canada (16-000216)

The claimant was involved in an MVA in December of 2013. An OCF-1 was submitted in February of 2014. Aviva sent OCF-9s in February, March, April, and May 2014, informing the Applicant that the MIG governed her injuries and as such she did not have coverage for attendant care benefits. The Applicant brought an application for arbitration in May of 2016 seeking attendant care benefits. Adjudicator Richards held that the limitation period did not begin to run until an application for ACBs had been made, and further, that the insurer’s denials were not clear and unequivocal.

J.T. v. Echelon General Insurance Company (16-000018)

The insurer’s denial of NEBs was dated April 8, 2014. The claimant applied to the LAT on April 8, 2016 to dispute his entitlement to NEBs. The insurer argued that the limitation period expired on April 7, 2016, because the date of denial had to be included in counting the two-year period. Vice Chair Flude disagreed with the insurer and held that the limitation period expired on the two year anniversary, and that the claimant’s application was therefore timely.