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Kasbar v. Travelers Insurance (19-009400)

  • March 30, 2021

A preliminary issues hearing was held to determine whether the claimant was barred from proceeding with a LAT application pursuant to s. 55(1) and s. 32(1) of the SABS for failure to notify the insurer of the circumstances giving rise to a claim for a benefit and/or not applying for a benefit within the times prescribed in the SABS. The claimant did not submit an OCF-1 until nearly 17 months after the accident. He submitted that he initially did not find it necessary to contact his insurer or make an application for accident benefits because he felt he was recovering from his accident-related injuries. When he believed his aches and pain post-accident were worsening, he retained a lawyer who submitted the OCF-1. Adjudicator Driesel reviewed the medical record, the motor vehicle accident report, case law on what constitutes a “reasonable explanation”, and the claimant’s examination testimony, and found that the claimant did not have a reasonable explanation for the delay in applying for accident benefits. The claimant was barred from proceeding with the LAT application.

Full decision here

TGP Analysis

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