2 total
Insurer must pay accident benefits as passenger reasonably believed unlicensed driver had owner's implied consent.
The applicant was injured as a passenger in a single-vehicle accident.
The vehicle was owned by the applicant's father and driven by the applicant's friend, who was unlicensed and had been drinking.
The respondent insurer denied the applicant's claim for statutory accident benefits, arguing that the applicant knew or ought reasonably to have known that the driver was operating the vehicle without the owner's consent, triggering the exclusion under s. 31(1)(c) of the Schedule.
The Tribunal found that the owner had given the applicant broad, unrestricted permission to allow others to drive, establishing implied consent.
Furthermore, the Tribunal held that an ordinary person in the applicant's position would have reasonably believed the driver had consent.
The exclusion did not apply, and the respondent was ordered to pay the disputed benefits.
Claims for a special award and costs were dismissed.
Insurer's preliminary motion dismissed; inadequate denial notice failed to trigger the two-year limitation period.
The applicant sought non-earner benefits following a motor vehicle accident, which the respondent insurer denied.
The respondent raised a preliminary issue that the applicant's appeal was statute-barred because it was not commenced within the two-year limitation period under section 56 of the Statutory Accident Benefits Schedule.
The Tribunal found that the respondent's Explanation of Benefits did not comply with the notice requirements of section 37(4) of the Schedule, as it failed to provide adequate medical and other reasons for the denial in plain language.
Consequently, the limitation period was never triggered, and the applicant's claim was not out of time.
