The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.
The insurer terminated benefits and the applicant applied for arbitration.
The insurer raised preliminary issues arguing the applicant was precluded from proceeding to arbitration under s. 50(a) of the Statutory Accident Benefits Schedule for failing to notify the insurer within prescribed time limits, and under s. 50(c) for failing to attend a Designated Assessment Centre (DAC) assessment.
The arbitrator found the insurer did not meet its burden to prove the applicant failed to apply within the time limits, as the insurer's own correspondence acknowledged receipt of the application.
However, the arbitrator found the applicant failed to attend a scheduled DAC assessment without explanation.
Consequently, the applicant was precluded from pursuing his claim for medical and rehabilitation benefits at arbitration, but could proceed on other issues.