E.Z. v. Co-operators General Insurance Company (19-006441)

The claimant applied to the LAT disputing entitlement to IRBs. The insurer paid IRBs prior to the hearing. The claimant requested a special award. Adjudicator Maleki-Yazdi granted a special award of 15 percent on the late payment of IRBs. She held that the insurer’s decision to not pay IRBs until after an EUO almost 12 months after the accident (and eight months after submission of the OCF-3 and OCF-2) was not reasonable. The main basis was not paying IRBs earlier was the insurer wanting to know the reason for the four month delay in applying for accident benefits. The insurer knew that the claimant was self-represented and knew that he was in the process of figuring out the AB forms. The claimant also faced a delay in obtaining the financial records needed for submission of the OCF-2.