Released Date: 08/14/2020
In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8., in relation to statutory accident benefits.
Between:
A.Q.
Applicant
and
Wawanesa Mutual Insurance Company
Respondent
PRELIMINARY ISSUE DECISION
ADJUDICATOR:
Jesse A. Boyce
APPEARANCES:
For the Applicant:
Jordan Palmer
For the Respondent:
Anju Sharma
HEARD:
Via written submissions
OVERVIEW
1A.Q. was injured in an accident on March 7, 2017, and sought various benefits, including attendant care benefits (“ACBs”) from the respondent, Wawanesa, pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (''Schedule'').
2Wawanesa paid for certain treatment but denied various medical and rehabilitation benefits and ACBs after A.Q.’s failure to attend for various s. 44 Insurer’s Examinations (“IEs”) to determine entitlement. In addition to his non-attendance, Wawanesa maintains that A.Q. failed to dispute its termination of ACBs within the two-year limitation period and is therefore statute-barred from proceeding. After A.Q. applied to the Tribunal for resolution of the dispute, Wawanesa raised the preliminary issues giving rise to this hearing.
ISSUES IN DISPUTE
3The following preliminary issues are in dispute:
i. Is the applicant barred from proceeding with his claim for an attendant care benefit denied by the respondent on May 12, 2017 because it is past the two-year limitation period from the date of denial pursuant to s. 56 (1) of the Schedule?
ii. Is the applicant’s claim statute barred pursuant to s. 55 of the Schedule?
RESULT
4A.Q. is statute-barred from proceeding with his claim for ACBs and is statute-barred from proceeding with all of his benefit claims where he failed to attend

