Steven Sieger

The insurer brought a motion arguing that the applicant's claim for an increased weekly income benefit rate was time-barred.

The insurer had reduced the applicant's benefits to the minimum rate in July 1994 based on an accountant's report, and the applicant did not apply for mediation until March 1997.

The arbitrator found that the insurer's July 1994 notices, combined with the provision of the accountant's report in November 1994, constituted clear and unequivocal notice of refusal.

The ongoing investigations and communications between the parties' accountants did not constitute a waiver of the limitation period or create an estoppel.

The motion was granted and the applicant's claim regarding the benefit rate was barred.

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

The insurer initially denied the claim on the basis that the applicant was receiving workers' compensation benefits.

When the workers' compensation benefits ended, the applicant submitted a revised claim, which the insurer subsequently denied on the merits.

The insurer argued the application for arbitration was barred by the two-year limitation period running from the initial denial.

The arbitrator held that the initial denial was conditional and only barred the claim for the period prior to the end of the workers' compensation benefits.

The claim for benefits after that date was subject to a new limitation period running from the second denial, and could therefore proceed.