D.G. v. RSA Insurance Company (19-004884)

The claimant sought entitlement to ACBs and HK expenses. The insurer argued that the claimant was barred from contesting the denials as she filed her application over two years after the benefits were denied. Adjudicator Mazerolle ruled that the claimant was allowed to proceed with her claim in accordance with Tomec v. Economical. He noted that the claimant only “discovered” her entitlement to post-104 week ACBs and HK expenses after she was deemed to suffer a catastrophic impairment, and any previous denial would not trigger the limitation period.