Michael Jenkins

The applicant requested a reconsideration of a Tribunal decision that found he was not involved in an 'accident' and allowed the insurer to terminate and seek repayment of benefits due to misrepresentation.

The applicant argued the Tribunal breached procedural fairness and erred in law by denying his request to adjourn the written hearing to an in-person hearing to assess credibility.

The Tribunal denied the reconsideration, finding the applicant had ample prior opportunity to request an oral hearing or submit affidavit evidence but failed to do so, and that the original decision relied on expert engineering evidence contradicting the applicant's sworn statements rather than a simple credibility assessment.

The applicant sought statutory accident benefits following an alleged motor vehicle collision.

The insurer denied benefits and sought repayment, arguing the collision was staged or did not occur as reported.

Relying on forensic engineering evidence that contradicted the applicant's version of events, the Tribunal found the applicant failed to prove he was involved in an 'accident' under s. 3(1) of the Schedule.

The Tribunal concluded the applicant wilfully misrepresented material facts, entitling the insurer to terminate benefits under s. 53 and ordering the applicant to repay $3,806.09 plus interest.

The insurer applied to the Licence Appeal Tribunal for repayment of medical benefits, insurer examination expenses, and adjusting expenses paid to the respondent, alleging the respondent staged the accident and wilfully misrepresented his claim.

The respondent did not participate in the hearing.

The Tribunal found that the respondent wilfully misrepresented the accident based on an engineering report and admissions.

The Tribunal ordered the respondent to repay $3,291.23 in medical benefits with interest.

However, the Tribunal dismissed the insurer's claims for repayment of insurer examination expenses and adjusting expenses, finding no basis in the Statutory Accident Benefits Schedule to recover such costs.

The Tribunal also denied the insurer's requests for a special award and costs.

The plaintiff alleged breach of contract, misrepresentation, bad faith, willful misconduct, personal injury, and negligence in breach of fiduciary duty against her insurance company, CAA, stemming from the handling of multiple car damage claims between 1993 and 2004, and subsequent alleged harassment.

The court found no evidence to support the plaintiff's claims of improper conduct by CAA or its employee, Joe Jansen, in the administration of the insurance claims or in post-claim interactions.

Expert evidence regarding the car damage and the plaintiff's medical condition did not establish a link between CAA's conduct and any alleged harm or losses.

The action was dismissed.

The applicant sought statutory accident benefits following an alleged motor vehicle collision.

The respondent denied the claim on the basis that the collision was staged and therefore not an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The adjudicator found the applicant's evidence unreliable due to significant inconsistencies with accident reconstruction expert evidence, surveillance video, and cell phone records.

The adjudicator concluded the collision was staged and dismissed the appeal.

The applicant sought statutory accident benefits following an alleged rear-end motor vehicle collision.

The respondent insurer denied the claim, alleging the collision was staged and that the applicant made a material misrepresentation.

The Licence Appeal Tribunal found that the applicant's evidence was logically inconsistent and contradicted by the respondent's accident reconstruction expert, who concluded the collision could not have occurred as the applicant described.

The Tribunal held that a staged collision does not meet the definition of an 'accident' under s. 3(1) of the Schedule, as it offends the public policy against profiting from intentional acts codified in s. 118 of the Insurance Act.

The Tribunal concluded the collision was staged, the applicant was not in an accident, and the respondent was entitled to terminate benefits under s. 53 of the Schedule due to the applicant's wilful material misrepresentation.

The applicants sought statutory accident benefits following a reported motor vehicle collision.

The insurer terminated benefits and sought repayment, alleging the collision did not occur as reported.

At a preliminary issue hearing, the arbitrator weighed competing accident reconstruction expert evidence and the applicants' testimony.

Finding the applicants' evidence credible and the applicant's expert persuasive, the arbitrator concluded on a balance of probabilities that the applicants were involved in an 'accident' as defined in section 2(1) of the Schedule.