The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
The insurer argued the applicant was only entitled to lower benefits under section 13 of the Schedule because he was not employed at the time of the accident, and that his application for arbitration was barred by the limitation period.
The arbitrator found that the applicant's receipt of a severance package and workers' compensation benefits did not extend his employment, making him eligible only for section 13 benefits.
However, the arbitrator held that the arbitration was not time-barred because the insurer's notice of assessment did not constitute a clear and unequivocal refusal to pay benefits.
