The minor claimant was involved in an accident in 2002. Only in 2016 did the claimant apply for accident benefits when he retained his current counsel (his former counsel sent a tort action letter to the insurer in 2014, but did not make an accident benefits claim.) Around three months after the AB application, the insurer responded requesting further information and an explanation for the delay. The claimant’s reasons for delay were that he was six years old when he was injured and that no one from the insurer had written to him or his parents to explain accident benefits coverage. The insurer denied the application as being made outside of the time limits without reasonable explanation. A preliminary issue hearing took place addressing the late application defence. Adjudicator Boyce concluded that the claimant was permitted to proceed with his application for accident benefits. He was critical of the insurer’s failure to notify the claimant of accident benefits after receiving the notice of tort action. He accepted that the claimant’s status as a minor at the time of the accident and the severe injuries he suffered made the reason for delay credible and reasonable. Further, Adjudicator Boyce noted that the claimant and his parents were recent immigrants with no knowledge of the insurance system or legal system in Ontario. Finally, he found limited prejudice to the insurer and noted the extensive medical documentation that existed to allow the insurer to obtain accurate information and effects of the accident on the claimant.
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