The insurer argued that the claimant was not involved in a legitimate accident, pointing to inconsistencies is the material facts leading up to the accident, the description of the accident, and the injuries sustained. Adjudicator Kaur rejected the insurer’s position, holding that the inconsistencies were minor, or were immaterial, or were not in fact inconsistencies when considered as a whole. The insurer also argued that the claimant’s five month delay in applying for benefits barred the claim. Adjudicator Kaur dismissed the insurer’s arguments as the insurer refused to produce its log notes detailing the interactions with the claimant. The claimant argued that the insurer refused to provide the necessary forms; the insurer did not produce evidence to the contrary.
Menu