The insurer sought repayment of benefits, the costs it incurred in conducting IEs, and the cost of adjusting the claim based on the claimant’s wilful misrepresentation and fraud. The claimant was unrepresented and did not participate in the proceedings. Adjudicator Ferguson agreed with the insurer’s submissions that, based on the evidence, the claimant was not in fact involved in the accident and that as the misrepresentation and fraud went to the entire claim for accident benefits, the claimant was liable to repay all sums paid by the insurer in relation to his claim ($2,400) plus interest. Adjudicator Ferguson denied the insurer’s request for payment for the costs of IEs and adjusting the claim, concluding that there was nothing in the SABS that created a repayment obligation for these costs.
