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I.G. v. Security National Insurance Company (19-000292)

  • October 21, 2019

The claimant sought entitlement to NEBs, ACBs, and various medical benefits. The insurer argued that the claimant failed to notify it of the circumstances giving rise to the claims, and failed to submit an application in the time prescribed. Adjudicator Boyce permitted the claim to proceed despite the late application. He accepted that the claimant believed her injuries would heal, but instead became progressively worse. He also noted that the insurer had been adjusting the claim for a number of year prior to the LAT application, and to argue that it was prejudiced appeared disingenuous. Adjudicator Boyce did, however, bar the claim for ACBs based on the claimant’s failure to submit a Form 1 during the first 104 weeks of the claim.

Full decision here

TGP Analysis

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  • FILED UNDER Attendant Care Benefits, Late Application
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