Sophia L. Dales

The applicant was injured in a snowmobile accident in 2012 but did not apply for statutory accident benefits until 2017, a delay of over five years.

The respondent insurer denied the claim based on the delay.

The Tribunal found that while the applicant's explanations regarding an abusive relationship and other hardships were credible, they did not reasonably explain the entire five-year and eight-month delay, particularly the two and a half years following her separation from her ex-husband.

The Tribunal held that the applicant failed to provide a reasonable explanation for the delay and is therefore statute-barred from proceeding with her application.

The insurer sought reconsideration of a Licence Appeal Tribunal decision that found the applicant entitled to payment for Lidocaine intravenous injections and a dietician assessment following a motor vehicle accident.

The insurer argued the Tribunal made significant errors of law and fact by misapprehending the 'reasonable and necessary' standard and improperly shifting the burden of proof.

The Vice-Chair dismissed the reconsideration request, finding that the original adjudicator properly considered the evidence, applied the correct legal standards, and made reasonable factual findings based on the medical evidence presented.