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Aviva Insurance Canada v. K.B. (19-008307)

  • September 3, 2020

The claimant was involved in an accident on November 10, 2015. The insurer paid the claimant IRBs from November 17, 2015 until December 10, 2018, based upon the OCF-1 and OCF-2 submitted by the claimant. The insurer terminated IRBs based upon multiple IE reports. The claimant disputed the insurer’s termination and in turn provided tax returns from 2012 to 2016. Upon review of the tax returns, the insurer noticed that the claimant had not declared any pre-accident employment income, contrary to her claims on the OCF-1 and OCF-2. The insurer sought repayment of IRBs in the amount of $15,028.57 plus interest under section 52 of the SABS, only for the 12 months preceding the request. The claimant did not make any submissions. Adjudicator Boyce awarded the insurer the full amount in repayment, plus interest, holding that the insurer’s request complied with section 52.

Full decision here

TGP Analysis

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  • FILED UNDER Repayment
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