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Laszlo v. Economical Mutual Insurance Company (20-001644)

  • March 31, 2021

The claimant sought entitlement to benefits and the parties attended a case conference where the insurer raised the preliminary issue of whether the claimant was statute barred from proceeding with her claim for an IRB pursuant to section 56 of the Schedule. Adjudicator Chakravarti determined that the claimant was statute barred and her appeal was dismissed. The claimant argued that there was no proper termination of the IRB due to the insurer’s non-compliance with section 37(5) and 37(6) of the Schedule, and therefore the limitation period was not triggered by the notice of denial on December 1, 2017. The insurer argued that the failure of an insurer to meet the timeline in section 37(6) (i.e. to provide the section 44 assessment reports to the claimant within 10 business days) is a minor error and standing alone it cannot support a finding in favor of the claimant with respect to the limitation issue. Adjudicator Chakravarti found that the late delivery of the section 44 reports did not prejudice the claimant and it was a minor error and not part of ongoing errors by the insurer. Adjudicator Chakravarti also considered the four Manuel factors in determining whether to extend the limitation period (the existence of a bona fide intention to appeal within the appeal period, the length of delay, prejudice to the other parties, and the merits of the appeal). Adjudicator Chakravarti found that the claimant had not persuaded that she had a bona fide intention to appeal within the appeal period and she failed to explain the length of the delay.

Full decision here

TGP Analysis

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  • FILED UNDER Limitation Period
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