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K.D. v. Wawanesa Mutual Insurance Company (18-001020)

  • August 15, 2018

The claimant’s mother was involved in an accident while an occupant of a friend’s vehicle. The mother did not have insurance of her own. The claimant applied for accident benefits under the friend’s policy. The insurer argued that the claimant was not an insured person under the policy and not entitled to accident benefits. Adjudicator Helt agreed with the insurer. As a preliminary issue, the adjudicator concluded that the LAT had jurisdiction to determine whether a claimant was an “insured person.” Turning to the claim itself, neither the claimant nor his mother had a familial or dependency relationship with the insurer’s policyholder. Finally, Adjudicator Helt rejected the claimant’s arguments that the insurer was estopped from arguing that he was not an insured person, writing that estoppel cannot be applied to create insurance coverage where none exists.

Full decision here

TGP Analysis

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