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Sambasivam v. Sonnet Insurance Company (20-014115)

  • May 30, 2022

The insurer brought a preliminary issue motion with the LAT to determine whether the accident alleged by the claimant had occurred. It sought a repayment of IRBs paid and costs for investigation and legal fees. The claimant alleged that he had been a passenger in a vehicle driven by the witness, his sister, when they were rear ended by an SUV. He claimed that their vehicle was pushed off the roadway by the impact into a post. The claimant stated that the SUV fled and that he and his sister called a tow truck to the scene. However, the claimant was unable to recall the object that the vehicle struck, the damage to the vehicle, and whether the airbags deployed. There was no external evidence to establish that he was present when the alleged accident occurred, aside from the accident report which was filed four days later. The claimant’s witness stated at the hearing that the vehicle had struck a tree. However, in the accident report she had claimed that the vehicle hit a post. The insurer hired an expert to conduct a forensic investigation of the matter. The expert noted that the rear of the vehicle had a series of scratches made by a sharp object that were separate and distinct, with no damage being found on the bumper or from one metre above the ground and below. He also found that the damage to the front of the vehicle was consistent with underriding because it widened as it developed into the hood area. Based on the evidence before him, Adjudicator Flude held that the claimant had misrepresented the material facts of the alleged accident. He ordered that the he repay $10,857.14 in IRBs with interest from April 16, 2021. However, he did not find that the insurer was entitled to costs related to the claim as the remedy was not found in the SABS. The claimant’s AB claim was dismissed.

Full decision here

TGP Analysis

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  • FILED UNDER Repayment, Material Misrepresentation
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