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Insurer estopped from relying on 90-day application limit; disability pensions deducted from weekly income benefits.
The Applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
The Insurer denied the claim on the basis that the Applicant failed to submit a completed application within 90 days of giving notice, as required by section 22(1) of the No-Fault Benefits Schedule.
The arbitrator found that the Insurer was estopped from relying on the time limit due to its own delay in providing the forms, and that the Applicant's personal circumstances provided a reasonable excuse.
The arbitrator held that the Applicant suffered a substantial inability to perform her essential tasks for three weeks following the accident, entitling her to weekly income benefits for that period.
However, the arbitrator concluded that the Applicant's CPP and Bell Canada disability pensions were payments for loss of income that must be deducted from the weekly benefits under section 13(3), resulting in no net weekly benefits payable.
The Applicant was awarded $1,557.00 for supplementary medical and rehabilitation expenses, plus related transportation costs.
