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B.T. v. St. Paul Fire and Marine Insurance Company(17-000086)

  • December 27, 2017

The claimant sought entitlement to IRBs and costs of examinations. As a preliminary issue, the respondent argued that the claimant was barred from appealing her claims as she had not followed the procedures for claiming accident benefits under section 32 of the SABS. The claimant did not file a claim for accident benefits until July 2016, two and a half years after the subject accident. No explanation for the delay was provided. Adjudicator Ferguson concluded that the respondent was not required to pay the claimant’s claim for IRBs, as she did not comply with the prescribed procedures for claiming accident benefits. However, the amounts incurred with respect to the costs of examinations were payable pursuant to section 38(11). The claimant filed two assessment plans in June 2016 which the respondent did not deny.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Medical Benefits, Late Application
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