David Kapanadze

This appeal addressed the application of the discoverability doctrine to the limitation period for income replacement benefits (IRBs) under the Statutory Accident Benefits Schedule (SABS).

The appellant insurer, The Personal Insurance Company (TPIC), argued that the Divisional Court erred in finding that the insured's application to the Licence Appeal Tribunal (LAT) was not limitations-barred.

The Court of Appeal affirmed that the doctrine of discoverability applies to IRB claims, consistent with its prior decision in Tomec.

It held that a pre-emptive denial of benefits by an insurer does not trigger the limitation period if the insured was not yet eligible for or had not applied for the benefits.

The Court found that the LAT adjudicator had not made an implicit factual finding regarding when the insured applied for benefits, thus allowing the Divisional Court to draw its own inferences.

The appeal was dismissed, upholding the Divisional Court's decision to remit the matter to the LAT for a new hearing on the substantive merits of the IRB claim.

The appellant appealed a Licence Appeal Tribunal decision denying his claim for income replacement benefits on the basis that it was barred by the two-year limitation period.

The appellant had returned to work immediately after the accident but stopped working 16 months later, at which point he applied for benefits.

The Divisional Court allowed the appeal, finding that the adjudicator erred in law by failing to apply the doctrine of discoverability.

Following Tomec, the court held that the limitation period could not begin to run before the appellant became eligible for the benefits.