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Shih v. Economical Insurance (20-005669)

  • February 3, 2021

The claimant sought entitlement to Income Replacement benefits and three treatment plans. The insurer raised a limitation defence in accordance with s. 56 of the Schedule. The insurer argued that the claimant failed to challenge the denial of the IRB and two of the three treatment plans within the two-year limitation period. Adjudicator Mazerolle found that the claimant was entitled to proceed with her application for IRBs, but not the two treatment plans. Both parties accept that more than two years had passed between the three denial dates and the filing of the application on May 8, 2020. However, both parties had differing positions on whether the statutory bar under s. 56 applies. Adjudicator Mazerolle found that the claimant was entitled to pursue her claim for IRBs as the limitation period (started by the April 17, 2018 denial) was suspended before the two-year mark due to the COVID Limitations Regulation. Section 2 of that Regulation was clear that any and all requirements to act within a certain period of timeframe within the province of Ontario were suspended as of March 16, 2020. This clear language provided no indication that there was a need to establish the pandemic “contributed or caused” the late filing. Rather, the freeze was automatic, and was in place at the time the claimant filed her application with the Tribunal. Finally, with respect to the treatment plans, Adjudicator Mazerolle concluded that the LAT did not have the authority to use s. 7 to extend the limitation periods for the two treatment plans that were filed following the two-year mark. This point has been debated at the Tribunal, with these competing positions laid out in two often-cited cases: i.e., A.F. v. North Blenheim Mutual Insurance Company and S.S. Certas Home and Auto Insurance Company.

Full decision here

TGP Analysis

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  • FILED UNDER Limitation Period
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