Category: Limitation Period

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the 90 day grace period which had applied at FSCO did not apply at the LAT, the claimant’s delay caused additional preliminary issues, the insurer was prejudiced because it might be unable to locate, produce, or rely on old evidence, and the claimant did not provide any evidence of the merits of the appeal.

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the 90 day grace period which had applied at FSCO did not apply at the LAT, the claimant’s delay caused additional preliminary issues, the insurer was prejudiced because it might be unable to locate, produce, or rely on old evidence, and the claimant did not provide any evidence of the merits of the appeal.

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the 90 day grace period which had applied at FSCO did not apply at the LAT, the claimant’s delay caused additional preliminary issues, the insurer was prejudiced because it might be unable to locate, produce, or rely on old evidence, and the claimant did not provide any evidence of the merits of the appeal.

The claimant was a minor at the time of the accident. The insurer denied NEBs around the six months mark. The claimant applied to the LAT to dispute NEBs more than two years after turning 18 years old. The insurer argued that the limitation period barred the claim. Adjudicator Johal agreed that the claim was statute barred even thought the initial denial did not indicate that the claimant was not entitled to NEBs until turning 18 years old. Adjudicator Johal also held that none of the factors relating to extending the limitation period under the Licence Appeal Tribunal Act applied to the claim: the claimant did not have a bona fide intention to appeal within the appeal period; the delay of eight months after the limitation period was not reasonable; the insurer would be prejudiced if the claim was to continue; and the merits of the claim were not enough to outweigh the remaining factors.

The claimant sought entitlement to attendant care benefits and housekeeping expenses after a catastrophic impairment application. The insurer argued that those benefits had been denied more than two years prior, and were therefore statute barred. Adjudicator Johal agreed with the insurer. He held that the denials of HK expenses and ACBs were clear and unequivocal despite referencing the wrong section numbers of the SABS. He also held that payment of past ACBs and HK expenses which were made in error after the catastrophic impairment determination did not negate the initial denial (the LAT application was made more than two years after the insurer notified the claimant of the error). Adjudicator Johal also noted that post-104 week HK expenses and ACBs were not new benefits, and that the denial of those benefits before the 104 week mark applied equally to those benefits after the 104 week mark. Finally, the adjudicator held that the catastrophic impairment determination did not support a “discoverability” argument that restarted the limitation period.

The claimant sought entitlement to attendant care benefits and housekeeping expenses after a catastrophic impairment application. The insurer argued that those benefits had been denied more than two years prior, and were therefore statute barred. Adjudicator Johal agreed with the insurer. He held that the denials of HK expenses and ACBs were clear and unequivocal despite referencing the wrong section numbers of the SABS. He also held that payment of past ACBs and HK expenses which were made in error after the catastrophic impairment determination did not negate the initial denial (the LAT application was made more than two years after the insurer notified the claimant of the error). Adjudicator Johal also noted that post-104 week HK expenses and ACBs were not new benefits, and that the denial of those benefits before the 104 week mark applied equally to those benefits after the 104 week mark. Finally, the adjudicator held that the catastrophic impairment determination did not support a “discoverability” argument that restarted the limitation period.

The applicant sought payment for IRBs. The respondent argued that the applicant’s claim was time-barred. The applicant submitted an OCF-1 in February 2012. State Farm denied the claim on March 8, 2012. The applicant submitted an OCF-3 in January 2017 after exhausting collateral benefits. State Farm denied the claim and requested additional financial documentation, but did not raise the limitation period issue. After receiving the requested financial documentation in November 2017, State Farm denied the IRB claim due to the limitation period. The applicant filed an application with the LAT in December 2017, over 5 years and 8 months from the first IRB denial. Adjudicator Sewrattan held that the applicant’s claim was time-barred and the applicant was not entitled to costs because the conduct complained about occurred outside of the LAT’s proceeding. The adjudicator held that the applicant made a claim when she submitted an application for ABs in February 2012, not when she first submitted a disability certificate in January 2017. The adjudicator further held that State Farm provided a clear and unequivocal denial of the applicant’s IRB claim and advised the applicant of her dispute resolution options on March 8, 2012. As such, the limitation period was March 8, 2014. The adjudicator rejected the applicant’s argument that State Farm was estopped from relying on the limitation period due to entertaining her IRB claim through 2017. The adjudicator held that tis conduct did not prejudice the applicant’s ability to comply with the limitation period.