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B.E.T. v. Wawanesa Mutual Insurance Company (19-008722)

  • October 14, 2020

The claimant applied to the LAT in relation to NEBs, which had been denied on January 28, 2016. In January 2019 the claimant submitted an OCF-19 for a catastrophic impairment designation. The IEs agreed with the OCF-19 and the claimant was granted a catastrophic impairment. The LAT application was made in December 2019 for NEBs. The insurer argued that the claim was time barred. Adjudicator Boyce held that the limitation period did not apply. He relied on the Court of Appeal’s reasons in Tomec, reasoning that the claimant’s subsequent deterioration meant that she could not discover her claim for NEBs until years after the accident. Adjudicator Boyce also held that he would have extended the limitation period pursuant to section 7 of the LAT Act. The claimant had a bona fide intention to appeal the NEB denial in 2016, but then decided not to pursue the dispute as she was improving at the time. There was merit to the claim, based on the claimant’s psychological status. There was no prejudice to the insurer as it continued to assess the claimant for other benefits, and the IEs completed for the catastrophic impairment application provided a thorough comparison of her life activities and circumstances.

Full decision here

TGP Analysis

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  • FILED UNDER Limitation Period
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