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Applicant v. TD Home and Auto Insurance Company (17-008493)

  • March 20, 2020

The claimant sought reconsideration of the Tribunal’s decision that his claim for ACBs and HK expenses was barred by the limitation period. Adjudicator Boyce granted the reconsideration request based on the Court of Appeal’s decision in Tomec v. Economical. The claimant’s ACBs and HK expenses had been denied in 2005. In 2015, the insurer accepted that the claimant suffered a catastrophic impairment, but refused to pay any ACBs or HK expenses based on the earlier denial. Adjudicator Boyce held on reconsideration that the claimant did not discover his claim for ACBs and HK expenses until he was determined to suffer a catastrophic impairment. He also held that the insurer’s denial in 2005 was pre-emptive and was not valid, because the claimant did not require such services at that time.

Full decision here

TGP Analysis

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  • FILED UNDER Limitation Period, Reconsideration
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