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M.S. v. Unifund Assurance Company (17-003419)

  • April 13, 2018

A preliminary issue hearing was held to determine whether the claimant was precluded from proceeding with a claim for income replacement benefits for her failure to dispute the denial of the benefit within the two year limitation period. The claimant argued that the limitation period did not run from the date of the insurer’s purported denial for two reasons: (1) the insurer violated s. 37 of the Schedule by failing to request a new OCF-3 prior to notifying the claimant that it required her to attend insurer assessments in a letter predating the denial; and (2) the denial of the IRB was not clear and unequivocal because the insurer subsequently sent the claimant a letter requesting further information relating to income and employment. Adjudicator Daoud rejected both arguments and held that the claimant was statute barred from disputing the denial of the income replacement benefit.

Full decision here

TGP Analysis

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  • FILED UNDER Limitation Period
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