Category: Limitation Period

The claimant applied to the LAT in relation to NEBs, which had been denied on January 28, 2016. In January 2019 the claimant submitted an OCF-19 for a catastrophic impairment designation. The IEs agreed with the OCF-19 and the claimant was granted a catastrophic impairment. The LAT application was made in December 2019 for NEBs. The insurer argued that the claim was time barred. Adjudicator Boyce held that the limitation period did not apply. He relied on the Court of Appeal’s reasons in Tomec, reasoning that the claimant’s subsequent deterioration meant that she could not discover her claim for NEBs until years after the accident. Adjudicator Boyce also held that he would have extended the limitation period pursuant to section 7 of the LAT Act. The claimant had a bona fide intention to appeal the NEB denial in 2016, but then decided not to pursue the dispute as she was improving at the time. There was merit to the claim, based on the claimant’s psychological status. There was no prejudice to the insurer as it continued to assess the claimant for other benefits, and the IEs completed for the catastrophic impairment application provided a thorough comparison of her life activities and circumstances.

The claimant sought entitlement to NEBs. The insurer argued that the dispute was time barred. Adjudicator Farlam held that the denial of NEBs was clear an unequivocal, and that it was delivered to both the claimant and the claimant’s legal representative. The LAT application was made more than three months after the expiry of the limitation period. Adjudicator Farlam held that the section 7 of the LAT Act should not be used to extend the limitation period. The claimant did not show a bona fide intention to apply to the LAT within the two years after denial. The claimant also failed to show that the NEBs claim had merit, relying only upon an OCF-3 that noted NEBs entitlement.

The claimant sought entitlement to IRBs, housekeeping expenses, and various medical benefits. The insurer argued that the application was barred by the limitation period. Vice Chair McGee held that the insurer’s denials were clear and unequivocal, regardless of whether they were correct to deny the benefits. With regard to section 7 of the LAT Act, Vice Chair McGee held that she did not have the authority to extend the limitation period. She also noted that some of the disputed benefits were applied for almost 10 years after the initial denials.

A minor claimant applied to the LAT disputing entitlement to medical benefits and the cost of an examination. The insurer argued that the claimant was statute-barred, as the claimant filed her LAT dispute more than 2 years after the denials of benefits. The claimant argued that as she was a minor, she was not statute-barred because she filed the LAT application within two years of turning 18 years old. The insurer argued that the claimant had a litigation guardian to protect her interests and therefore, the claimant did not have a reasonable excuse for the late application and her dispute was outside the limitation period. Adjudicator Johal agreed with the insurer. Adjudicator Johal found that this was not a case to override the requirements of the Litigation Act and that the claimant had not satisfied that she had a bona fide intention to apply to the LAT within the appeal period and that she did not prove that there was a reasonable explanation for the delay. Adjudicator Johal also agreed that the insurer was prejudiced due to the uncertainty and delay over the adjudication of benefits.