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Snagg v. Certas Home and Auto Insurance Company (20-003642)

  • July 7, 2021

A preliminary issue hearing was held to address whether the claimant was barred from proceeding with his claim for NEBs due to failure to submit a completed OCF-3. The claimant submitted an OCF3 which endorsed that he did not meet the test for NEBs. The insurer subsequently denied NEBs which led to the claimant commencing a dispute at the LAT. The insurer argued that the OCF3 could not be considered complete as it did not support entitlement to NEBs. The claimant relied on the case of 16-000279 v. Certas Home and Auto Insurance Co where the Tribunal found that the claimant had successfully applied for NEBs despite an OCF3 indicating that the claimant was not eligible. Adjudicator Norris agreed with the claimant, finding that the submitted OCF3 contained all of the evidence that the insurer required to make a decision and highlighted that the insurer’s actions (denying NEBs on the basis of the OCF3) supported this point. The claimant was allowed to proceed with his application.

Full decision here

TGP Analysis

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