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M.T.G. v. Aviva General Insurance (17-002122)

  • February 11, 2020

The claimant requested an extension under section 7 of the LAT Act to extend the limitation period beyond the two year statutory limits to dispute his entitlement to IRBs. The insurer denied IRBs on February 15, 2015, the claimant then initiated a FSCO dispute with a mediation scheduled for May 28, 2016. Claimant’s counsel submitted a Request for Failed Mediation Report to FSCO on May 26, 2016 and FSCO closed the file on May 28, 2016. The two year limitation expired on February 15, 2017 and the claimant filed with the LAT on March 31, 2017. Vice Chair Flude concluded that the claimant had failed to prove there was a clear intention to appeal during the limitation period, as he had been undeniably aware of the denial letter and limitation since at least February 6, 2017 when settlement discussions took place and did not move expeditiously to file a dispute. The adjusting notes from this insurer also noted that the claimant’s counsel had not yet decided whether to appeal the denial, and would speak to the claimant and get back to the adjuster. The dispute was not filed until over a month later on March 31, 2017. Vice Chair Flude also noted that the claimant had failed to provide any evidence that should his extension be allowed to proceed that he would be entitled to IRBs, instead providing a statement claiming he was not working and on social assistance with no evidence of the same.

Full decision here

TGP Analysis

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  • FILED UNDER Limitation Period, Reconsideration
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