The insurer denied benefits and claimed repayment alleging that the claimant had made wilful misrepresentations. The insurer stated that the claimant, who was the driver in the subject accident, had misrepresented that a second claimant (“Dawkins”) had been a passenger in his vehicle when the collision incurred. The claimant did not attend the hearing. Adjudicator Shapiro first found that the Tribunal could proceed in the claimant’s absence as adequate notice had been provided. Turning to the evidence, he found that Dawkins had not been in the vehicle and that the claimant had made a wilful misrepresentation for several reasons. First, the Motor Vehicle Collision Report referenced that the claimant and three other passengers had been in the vehicle, but did not mention Dawkins. Second, another driver involved in the collision provided a written statement and specifically noted that the front passenger seat had been empty. Finally, the accounts given by the claimant, Dawkins, and a passenger in the claimant’s vehicle contradicted one another. However, Adjudicator Shapiro held that the claimant’s misrepresentations did not terminate his benefits or trigger repayment under sections 53 and 52, as the claimant had not received his benefits as a result of the misrepresentation.
