Shawn Jafari

The applicant was injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated housekeeping benefits and provided an Explanation of Benefits.

More than two years later, the applicant applied for arbitration.

The insurer raised a preliminary issue that the application was statute-barred.

The arbitrator found that the Explanation of Benefits complied with the legal requirements and that the application was filed beyond the two-year limitation period.

The application for arbitration was dismissed, and the applicant was ordered to pay the insurer's expenses.

The applicant was injured in a motor vehicle accident and sought caregiver and housekeeping benefits.

The insurer brought a preliminary issue arguing the applicant was barred from proceeding to arbitration under section 32 of the Statutory Accident Benefits Schedule because she did not submit her expense forms until nearly a year after receiving the application package.

The arbitrator found that the applicant had provided sufficient information to notify the insurer of her claims in a timely fashion.

Furthermore, the insurer failed to inform the applicant of the consequences of failing to provide the requested information, precluding it from relying on the time limit to defeat her claims.

The preliminary issue was resolved in favour of the applicant.