Sam C Pitaro

The respondent insurer requested a reconsideration of a Tribunal decision that found the applicant entitled to an income replacement benefit.

The applicant, a pedestrian, was struck by a driver whose insurance policy with the respondent had expired.

The respondent argued the Tribunal acted outside its jurisdiction by effectively deciding a priority dispute and erred in finding the applicant was an 'insured person'.

The Tribunal dismissed the reconsideration request, finding no jurisdictional error or error of law.

It affirmed that the original decision correctly applied the 'nexus' test from Kingsway, establishing that the applicant's reliance on information that the driver was insured by the respondent created a sufficient connection to require the respondent to adjust the claim pending any priority dispute.

The applicant was involved in a motor vehicle accident and sought an income replacement benefit (IRB) from the respondent insurer.

The Tribunal found that the applicant sustained an accident-related psychological impairment that caused a substantial inability to perform the essential tasks of her pre-accident employment as a grocery store cashier.

Furthermore, the Tribunal determined that this impairment caused a complete inability to engage in any reasonably suited employment past the 104-week mark, but that this complete inability resolved by June 2, 2023, when she was ready to return to work.

The applicant was awarded an IRB of $400 per week from October 4, 2020, to June 2, 2023, plus interest on overdue payments.