The insurer argued that the claimant was precluded from proceeding to a hearing on the basis that the claimant’s dispute was statute barred pursuant to s. 55 of the Schedule. Adjudicator Manigat concluded that the claimant’s application for IRBs could proceed and that it was not statute barred. A denial of a benefit by an insurer must be delivered to an insured person in accordance with s. 64 of the Schedule. This section requires denial notices to be in writing, and permits delivery by various means, including regular mail, registered mail and by fax, to an insured person’s legal representative. It is only once an insurer has delivered a denial notice in accordance with s. 64 that the two-year limitation period set out in s. 56 of the Schedule begins to run. In this case, the insurer knew that the claimant was represented by counsel, but only delivered a stoppage letter to the insured in 2015. A copy was of the stoppage was not delivered claimant’s counsel by the insurer until 2019. The limitation period therefore did not begin until 2019.
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