P.W. v. Certas Home and Auto Insurance Company (19-002813)

The claimant disputed entitlement to IRBs. The insurer denied IRB entitlement in March 2014. Adjudicator Farlam held that the denial of IRBs was clear and unequivocal and that the limitation period expired in March 2016. The insurer’s subsequent communications requesting further information regarding work status did not restart the limitation clock, nor did each subsequent denial of IRBs constitute a new denial from which the limitation period ran. Adjudicator Farlam rejected the claimant’s argument that the discoverability principle from Tomec v. Economical applied; the claimant knew that she was not working after the denial of IRBs and chose not to dispute her entitlement. Finally, Adjudicator Farlam held that section 7 of the LAT Act should not be used to extend the limitation period because the claimant did not demonstrate a bona fide or good faith intention to appeal within the appeal period.