Rinaldo DiVincenzo

The insured, holding a G1 novice driver's licence, was injured in a motor vehicle accident while driving without an accompanying fully licensed driver, in violation of his licence conditions.

The insurer denied income replacement benefits, relying on the exclusion in s. 30(1)(b) of the SABS-1996 for driving 'without a valid driver's licence'.

The Director of Arbitrations allowed the insured's appeal, holding that the exclusion must be strictly construed and read in conjunction with the definition of 'valid driver's licence' in the Highway Traffic Act regulations.

Because the insured's licence was not expired, cancelled, or suspended, he had a valid driver's licence, and the exclusion did not apply despite his breach of the G1 conditions.

Following a decision denying the applicant's claim for income replacement benefits, the insurer sought an award of its arbitration expenses, alleging the applicant caused delays and called unnecessary witnesses.

The arbitrator found no evidence of intentional obstruction or neglect by the applicant, noting the insurer raised its successful exclusion defence only a month before the hearing.

The arbitrator concluded that the applicant acted in good faith and ordered each party to bear its own costs.

The applicant was injured in a motor vehicle accident while driving with a G1 novice licence without an accompanying fully licenced driver, in violation of his licence conditions.

He applied for income replacement benefits.

The insurer denied the claim under s. 30(1)(b) of the Statutory Accident Benefits Schedule, arguing he was driving without a valid driver's licence.

The arbitrator held that breaching the novice licence restriction constituted driving without a valid licence within the meaning of the exclusion.

The arbitrator also found that the insurer did not waive its right to assert the exclusion despite initially paying benefits, as there was no intentional relinquishment of the right.

The arbitration was dismissed.