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Ababio v. TD Insurance Meloche Monnex (20-001415)

  • October 7, 2021

The insurer denied IRBs effective March 12, 2019, but paid the claimant in error. The insurer requested repayment from the claimant under section 52 of the SABS. The claimant did not repay the requested amount, stating he was unable to work since the subject accident, and only began to work again in January 2020. The claimant filed a LAT Application claiming ongoing IRBs and various medical benefits; the insurer claimed repayment. Vice Chair Farlam ruled in the insurer’s favour, noting that a review of the claimant’s employment documents and union file showed that he was paid for 219 hours of work during the time he was receiving an IRB from the insurer. Furthermore, his treatment records indicated that he complained of a sore back “after work” during this time period, and that the EI file noted that the claimant left his job post-accident due to a “stoppage of work/end of contract” and not due to the accident. Vice Chair Farlam ruled that the requests for repayment under section 52 were complaint, even though the amounts requested were adjusted by the insurer as more evidence became available. She awarded the insurer $1,619.99 in overpaid IRBs plus interest. The remainder of the claimant’s application was dismissed.

Full decision here

TGP Analysis

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