A preliminary issue hearing was held to determine whether the claimant’s application was statute-barred from appealing the denial of IRBs and medical benefits because the claimant failed to commence her appeal within two years. Adjudicator Paluch found that the claimant was statute barred from proceeding with her claim for IRBs and medical benefits . In Adjudicator Paluch’s analysis, he referred to the principals outlined in Smith and Co-Operators General Insurance Company to determine whether a denial was proper. Adjudicator Paluch failed to understand the claimant’s argument that the insurer’s denial date was something different than the actual date of the denial letter. Under section 56, the limitation period begins to run from the date of denial and not by the effective stoppage date of the benefit as argued by the claimant. In regard to the medical benefits, Adjudicator Paluch found the insurer had unequivocally informed the claimant of her right to dispute the denials, the reasons for the decision, the two year limitation period to dispute the claim, detailed the necessary steps to file an application and invited the claimant to contact the adjuster for assistance, if needed. The claimant had not offered any excuse for the delay in disputing the treatment plans. The claimant also sought relief from the expiry of limitation period under section 7 of the LAT Act. Adjudicator Paluch held that section 7 of the LAT Act did not apply because the limitation period for accident benefits claims is fixed under a regulation, the SABS, and not by or under any Act. Adjudicator Paluch therefore determined that he did not have jurisdiction to extend the limitation period.
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