2 total
Arbitration application dismissed as statute-barred; relapse does not restart limitation period without continuous disability.
The applicant was injured in a motor vehicle accident and received weekly income benefits for 156 weeks.
The insurer terminated benefits in October 1994, stating the applicant did not meet the post-156 week disability test.
The applicant did not dispute the termination at the time.
In 1998, the applicant claimed a relapse and sought benefits from September 1997 onwards.
The arbitrator held that the applicant was precluded from proceeding to arbitration because the two-year limitation period under the Insurance Act and the Statutory Accident Benefits Schedule had expired following the initial clear and unequivocal refusal in 1994.
The arbitrator rejected the argument that a relapse could trigger a new limitation period without continuity of disability.
Claim for spousal death benefits dismissed as applicant and deceased did not maintain a conjugal relationship.
The Applicant claimed $50,000 in spousal death benefits following the death of his alleged spouse in a motor vehicle accident.
The Insurer denied the claim on the basis that the Applicant and the deceased were not spouses, as the Applicant had moved out of their shared residence more than a year prior to the accident.
The Arbitrator found that the parties did not share a joint intention to separate temporarily, nor did they maintain an integrated relationship characterized by financial interdependence or shared household responsibilities.
The application for death benefits was dismissed, though the Applicant was awarded reasonable expenses for the hearing.
