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Aviva General Insurance Company v. Gurung (20-000592)

  • January 29, 2021

The insurer sought repayment of all IRBs paid to the claimant, totaling $36,456, based on the claimant failing to notify the insurer that she was earning income as the owner of a restaurant. The insurer argued that it was entitled to repayment of more than one year of IRBs because the overpayment was due to the claimant’s willful misrepresentation. Adjudicator Lake granted the insurer’s request for full repayment of IRBs. She held that the claimant made misrepresentations at an examination under oath, during IEs, and on OCF forms. Tribunal case law held that a misrepresentation was “”any manifestation by words or other conduct by one person to another that, under the circumstances, amounts to an assertion not in accordance with the facts””. This could include “”silence or a failure to report””.

Full decision here

TGP Analysis

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  • FILED UNDER Repayment
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