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Y.G. v. TD General Insurance Company (18-012431)

  • September 2, 2020

The claimant sought entitlement to the cost of psychological and orthopaedic assessments. The insurer argued that the disputes were barred by the limitation period. The insurer denied the claimed assessments by letter dated March 1, 2016 due to insufficient medical documentation to support injuries outside of the MIG. The letter also advised the claimant that IEs would be arranged. The claimant had commenced her first LAT application on November 15, 2016, which was dismissed on the basis that the claimant failed to attend an IE. The claimant subsequently attended IEs. The claimant’s injuries were found to fall outside of the MIG. The claimant then submitted a second application on December 12, 2018. Adjudicator Moten found that the claimant did not commence her application within two years of the initial denial. However, he ordered the limitation period extended under section 7 of the LAT Act. The claimant had a bona fide intention to appeal the denials within the limitation period, and the claimant’s representative had communicated the intention to the insurer. The delay in appealing was 9.5 months, which Adjudicator Moten found not to be egregious. Finally, since the claimant suffered non-minor injuries, there was potential merit to the claims.

Full decision here

TGP Analysis

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  • FILED UNDER Limitation Period
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