Applicant precluded from arbitrating benefits after missing two-year limitation period to dispute insurer's refusal.
The Applicant was injured in a motor vehicle accident and received attendant care and housekeeping benefits for 104 weeks.
The Insurer then issued a refusal to pay further benefits, citing the 104-week limit.
Over eight years later, the Applicant disputed the refusal, arguing that the limitation period did not apply because he was later deemed catastrophically impaired, which would entitle him to post-104 week benefits.
The Arbitrator held that the Insurer's refusal was clear and unequivocal, and the Applicant missed the two-year limitation period to dispute it.
The Applicant is therefore precluded from proceeding to arbitration regarding his entitlement to these benefits.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesNov 18, 2016
