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Achaia-Shiwram v. Intact Insurance Company (20-004699)

  • March 23, 2023

The claimant applied to the LAT disputing her entitlement to IRBs and CAT impairment. The respondent raised a preliminary issue that the claimant did not dispute IRB entitlement within 2 years pursuant to s. 56. At the beginning of the in-person hearing, the claimant attempted to summons two witnesses, the claims adjuster and the CAT OT IE assessor. The respondent objected to these witnesses as the claimant had not provided their names on the witness list provided to the respondent and because the claimant had not properly served a summons to witness on either the claims adjuster or the CAT OT IE assessor. Adjudicator Hines agreed with the respondent noting that the potential witnesses were not served with a summons despite the claimant having ample time to do so. Adjudicator Hines also noted that because the claimant did not include them on their witness list, the respondent would be prejudiced by adding them as witnesses on the eve of the hearing, as the respondent would not have had time to prepare for examinations. The claimant also brought a motion to exclude an IE report based on the hourly rate charged by the IE doctor. The IE doctor confirmed her hourly rate was $225 hour and charged $3,375 for the IE assessment. However, the respondent provided an OCF-21 invoice that confirmed it paid the IE assessor $2,000 as per s. 25 of the SABS. Adjudicator Hines allowed the IE report as evidence. As for the substantial issues, Adjudicator Hines preferred the evidence of the IE assessors with respect to CAT and noted that causation was a major factor. With respect to causation, Adjudicator Hines noted that the claimant argued that the accident caused a decline in her employment performance; however, her failure to submit post-accident employment records to this effect weakened her argument. Adjudicator Hines also pointed to an intervening event of a volleyball injury, which caused further deterioration in the claimant’s condition and ability to work. Adjudicator Hines found that the claimant did not meet her onus of proving that but for the accident she would not have sustained the psychological impairment which formed the basis of her CAT application and IRB claim. As Adjudicator Hines concluded that the claimant did not meet the IRBs disability test, she did not rule on the s. 56 limitation period argument.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Catastrophic Impairment
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