The claimant applied to the LAT disputing entitlement to the MIG status and medical/rehabilitation benefits. Concurrently, the insurer sought a repayment of approximately $5,000 in medical benefits paid above the MIG limits. Adjudicator Lake found the insurer was not entitled to the repayment. The claimant applied to two insurers for benefits: BelairDirect and Zenith. After a priority dispute, Belair paid Zenith approximately $5,000 for reimbursement of benefits paid. Adjudicator Lake held that s. 52 of the SABS is limited to repayment of benefits paid to a person as a result of an error, or as a result of willful misrepresentation or fraud. Adjudicator Lake agreed that the claimant made several misrepresentations in this matter, including his failure to report the involvement of two insurers in his claim. However, Adjudicator Lake found that s. 52 only permits repayment of benefits that were “paid to a person” and because the insurer reimbursed Zenith directly, the insurer was not entitled to repayment under s. 52.
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