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X.J.W. v. Certas Home and Auto Insurance Company (19-000222)

  • February 25, 2020

This preliminary hearing was brought to determine whether the claimant was statute barred from appealing the insurer’s denial of his claims for medical benefits and IRBs because the appeal was filed more than two years after the denials. The claimant had applied for a FSCO mediation in April 2016 in regard to the denials, and his FSCO file was closed on June 15, 2016. The claimant conceded that he did not file his LAT dispute within the two year limitation period but argued that there was confusion over the closure date of the file due to the transition to the Tribunal from FSCO. The claimant submitted that the Tribunal should extend the deadline to appeal the denials pursuant to section 7 of the LAT Act. Adjudicator Victor found no evidence to indicate an intention to apply to the LAT within the appeal period and found that the claimant’s appeal was statute-barred.

Full decision here

TGP Analysis

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