Harrison Griffiths

The applicant insurer applied to the Licence Appeal Tribunal seeking a declaration that the respondent was not involved in an accident, termination of benefits for wilful misrepresentation, and repayment of benefits.

The respondent did not participate in the written hearing.

Relying on an expert engineering report, the adjudicator found that the damage to the respondent's vehicle was inconsistent with his report of a rear-end collision and was instead caused by multiple impacts with metal tubing and a low-speed sideswipe.

The adjudicator concluded the respondent failed to prove he was in an accident under s. 3(1) of the Schedule and found he wilfully misrepresented material facts.

The insurer was entitled to terminate benefits and recover $200 paid for an OCF-3, plus interest, but not $100 for employment records.

The insurer's request for costs was dismissed.

The insurer applied to the Licence Appeal Tribunal, arguing the respondent was not involved in a motor vehicle accident and had wilfully misrepresented material facts to obtain statutory accident benefits.

Relying on an expert engineer's report, the Tribunal found the vehicle damage was inconsistent with the respondent's claim of a rear-end collision and was instead caused by deliberate impacts with metal tubing and a stationary object.

The Tribunal concluded the respondent failed to prove she was in an 'accident' under section 3(1) of the Schedule and held the insurer was entitled to terminate benefits under section 53 due to wilful misrepresentation.

The insurer's request for costs was dismissed.

The applicant insurer sought a determination that the respondent was not involved in an 'accident' under s. 3(1) of the Schedule and sought repayment of benefits paid due to wilful misrepresentation.

The respondent did not participate in the written hearing.

Relying on an engineering assessment report, the Tribunal found that the damage to the respondent's vehicle was inconsistent with her reported version of events and was likely caused by multiple separate impacts with metal tubing.

The Tribunal concluded the respondent was not involved in an accident and had wilfully misrepresented material facts.

The applicant was entitled to terminate benefits and was awarded a repayment of $200.00 for an OCF-3, but its request for repayment of medical record costs and its request for costs of the proceeding were denied.

The insurer applied to the Licence Appeal Tribunal, arguing the respondent was not involved in a motor vehicle accident and had wilfully misrepresented material facts to obtain accident benefits.

The Tribunal preferred the insurer's engineering expert evidence, which concluded the vehicle damage was caused by metal tubing and a stationary sideswipe, over the respondent's uncorroborated account of a hit-and-run collision.

The Tribunal found the respondent failed to prove she was in an 'accident' under section 3(1) of the Schedule and held she committed wilful misrepresentation.

The insurer was entitled to terminate benefits and recover a $200 repayment for an OCF-3, plus interest, but its claim for $35 in medical record costs and $1,000 in proceeding costs was dismissed.

The applicant insurer sought a determination that the respondent was not involved in an "accident" as defined in s. 3(1) of the Statutory Accident Benefits Schedule, and sought repayment of benefits paid due to wilful misrepresentation.

The respondent did not participate in the written hearing.

Relying on an engineering assessment that concluded the vehicle damage was inconsistent with the respondent's reported rear-end collision and was instead caused by multiple impacts with metal tubing, the adjudicator found the respondent failed to prove she was in an accident.

The adjudicator held the applicant was entitled to terminate benefits under s. 53 for wilful misrepresentation and ordered the respondent to repay $200 for an OCF-3, plus interest.

The applicant's request for costs was denied.