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D.M. v. Aviva Insurance Company (17-006525)

  • May 27, 2020

This is a re-hearing decision heard in writing after the insurer made a request for reconsideration on the basis that the LAT made significant errors of fact and law in the initial hearing decision. The issue was whether post-accident money received by the claimant was a gift or income that was deductible from IRB payments. The claimant submitted that she continued to receive her regular pay from her mother’s restaurant after the accident, despite not working in the restaurant, as a way for her mother to help her financially, and that the money was a gift. The insured submitted that the amount was employment income as the claimant declared the income on her income tax returns and deductions were made for income tax, EI, and CPP contributions. In the initial hearing, Adjudicator Johal found that the money received by the claimant was a gift and not deductible. After the re-hearing, Adjudicator Johal found that the claimant did not have to be actively engaged in work, or “doing work in exchange for money”, in order to be considered to be receiving income as a result of employment. The insurer was entitled to deduct 70% of the post-accident income from IRB payments.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Reconsideration
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