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K.T. v. Allstate Insurance Company of Canada (16-000151)

  • February 3, 2017

The claimant was a pedestrian knockdown in Ontario. She applied for and received accident benefits, including IRBs, under Quebec’s Quebec Societe de l’assurance automobile. Her IRBs were terminated 11 months post-accident and she did not appeal the decision. She then applied for IRBs in Ontario. The insurer paid IRBs and terminated benefits up to and slightly beyond the 104-week cut-off. The insurer raised a preliminary issue stating that the claimant was not entitled to IRBs as she was a Quebec resident at the date of loss and entitled to benefits under Quebec’s insurance regime. Adjudicator Pay found the claimant was entitled to pursue an IRB claim in Ontario. Adjudicator Pay noted that the Ontario regime was designed with consumer protection in mind, and the Schedule did not contemplate residency of the insured other than for accidents outside Ontario. Therefore, if the accident occurred in Ontario, the claimant has access to the SABS.

Full decision here

TGP Analysis

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