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Adjetey v. Economical Insurance (22-000712)

  • January 16, 2023

This is a preliminary decision regarding late notice to the insurer. The claimant applied for accident benefits two years after the accident. Section 32(1) of the SABS provides that the insured must give notice of the intention to claim benefits within 7 days of the loss date. The claimant conceded that they were two years late but argued that they had a reasonable explanation under s. 34 of the SABS. The claimant explained that since their impairment stemmed from two accidents, and as time progressed they learned that their impairment was caused by the subject accident. The claimant did not provide any substantive evidence for their impairment. The insurer was not required to send an OCF-1 as it did not know about the accident. The Adjudicator found that the claimant failed to provide a reasonable explanation for failure to comply with timelines under the SABS. The LAT application was dismissed.

Full decision here

TGP Analysis

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  • FILED UNDER Late Application
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