Claim for accident benefits dismissed and repayment ordered due to material misrepresentations by the insured.
The insured sought income replacement benefits following an alleged motor vehicle accident.
The insurer brought a preliminary issue motion arguing the insured made material misrepresentations regarding his primary residence when applying for the policy and regarding the circumstances of the accident.
The Tribunal found that the insured misrepresented his primary residence to obtain a lower premium and misrepresented the facts of the alleged accident.
As a result, the insured failed to meet his burden of proving he was involved in an 'accident' under the Statutory Accident Benefits Schedule.
The Tribunal dismissed the claim and ordered the insured to repay $10,857.14 in income replacement benefits previously paid by the insurer.
OLATOntario Licence Appeal TribunalMay 30, 2022
