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Insurance Claim
& Litigation Updates

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Keep in touch with the latest Insurance Claim & Litigation Updates including
our summaries on decisions and how they could impact your future claims.

IRBs Denied Based on Delayed OCF Submissions & Unverified Post-Accident Bank Deposits

September 27, 2021

When does entitlement to income replacement benefits (IRBs) commence if there is a delay between submitting an Application for Accident Benefits (OCF-1) and a completed ...

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Decision that EI Sickness Benefits are Not Deductible from IRBs Upheld after Appeal

August 26, 2021

The recent Licence Appeal Tribunal reconsideration decision, Tania Spence v. Aviva Insurance Company of Canada (19-013457/AABS) was dismissed as Adjudicator Boyce found no error of ...

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Adjudicator Rules on Sufficient Documentation for IRB Calculation

August 19, 2021

In the recent Licence Appeal Tribunal (“LAT”) decision Parameswaralingam v. Echelon General Insurance Company (19-005907/AABS), Adjudicator Lake ruled that although the Applicant was entitled to ...

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How do the CERB & CRB Impact the Calculation of IRBs?

July 27, 2021

How do the Canada Emergency Response Benefit (“CERB”) and Canada Recovery Benefit (“CRB”) impact the calculation of income replacement benefits (“IRBs”)? a) Are CERB and ...

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Request for Repayment on Overpaid IRBs

May 19, 2021

In the recent Licence Appeal Tribunal decision, Murphy v. Wawanesa Mutual Insurance Company (19-006006/AABS), Adjudicator Boyce ruled that Wawanesa is entitled to the repayment of ...

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EI Sickness Benefits are Not Deductible when Calculating IRBs

April 1, 2021

In the recent Licence Appeal Tribunal decision, Tania Spence and Aviva Insurance Company of Canada (19-013457/AABS), Adjudicator Boyce ruled that Employment Insurance (“EI”) sickness benefits ...

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Adjudicator Allows Insurer to Recover Overpaid IRBs Beyond Section 52 Threshold

March 15, 2021

In the recent Licence Appeal Tribunal (“LAT”) decision, Aviva General Insurance Company and B.G. (20-000592/AABS), Adjudicator Lake ruled that willful misrepresentation warranted Aviva the ability ...

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IRB Deductibility of EI Maternity Benefits Received & Employer Top-Up Benefits Available

March 8, 2021

Are Employment Insurance (“EI”) maternity benefits received and employer maternity top-up benefits available, however, not applied for, deductible when calculating an individual’s income replacement benefits ...

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Value of Lodging and Meals for IRB Purposes

January 26, 2021

In the License Appeal Tribunal decision, B. L. J. and The Co-Operators Insurance Company (18-012005/AABS), the adjudicator was required to determine if meals and free ...

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Pre-Accident Cash Income Should Be Verified As Opposed To Accepted At Face Value

November 26, 2020

Should pre-accident cash income that has not been evidenced with supporting documentation be considered at face value when calculating an individual’s income replacement benefits (IRBs)? ...

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Adjudicator Accepts Revised Tax Return

November 9, 2020

In the License Appeal Tribunal (LAT) decision N.F. and Aviva Insurance Canada (18-007077/AABS), the adjudicator was faced with the decision of accepting an amended tax ...

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LTD Settlement Not Deductible from IRB

October 28, 2020

Typically, when an individual is claiming an IRB and has LTD benefits available to them, our first thought is to deduct the LTD benefits received ...

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Post-Accident Monies Claimed to be a Gift Considered as Income

September 29, 2020

If an individual receives post-accident monies from their non-arm’s length employer, which they claim to be a gift, would an insurer be able to deduct ...

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Eligibility for Income Replacement Benefits not Based on CPP Disability Benefits Received Beyond 104 Weeks

September 28, 2020

One may assume that a claimant who commences receiving Canada Pension Plan (“CPP”) disability benefits after an accident would be eligible to receive income replacement ...

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Are Insurers Obligated to Pay for Plaintiff Accounting Reports?

May 28, 2020

A growing trend has emerged recently as it relates to individuals making a claim for income replacement benefits (“IRBs”).  More frequently than ever, insured’s seem ...

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Self-Employed Individuals – Last 52 Weeks or Last Completed Taxation Year?

May 20, 2020

For self-employed individuals seeking to claim an income replacement benefit (“IRB”), the calculation of their pre-accident gross weekly income is not always straightforward.  Two recent ...

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LAT rules on Section 8(1) for IRB Purposes

March 19, 2020

In the LAT decision released on January 13, 2020, T.A.K. v Aviva General Insurance Company (18-008232/AABS), the Adjudicator provides interpretation for the Section 8(1) adjustment ...

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Employed During a Period of Illness?

December 4, 2019

In the recent Licence Appeal Tribunal decision released on September 30, 2019, P.K. and Pembridge Insurance Company (Tribunal File Number: 18-000865/AABS), Adjudicator Reilly concludes that ...

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Shareholder of a Business – Employed or Self-Employed?

November 28, 2019

In the recent Licence Appeal Tribunal decision released on October 8, 2019, A.P. and Economical Insurance (Tribunal File Number: 19-000026/AABS), the Adjudicator found that A.P. ...

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Calculating Pre-Accident Income When Considering Self-Employment Losses

July 17, 2019

In the LAT reconsideration decision released on June 5, 2019, Aviva Insurance Canada v. W.D.W. (17-005894/AABS), it was determined that the Tribunal made an error ...

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Considering “Big Picture” to Determine Dependency

January 21, 2019

In the recent decision released on December 21, 2018, between Pafco Insurance Company (Applicant) and Wawanesa Mutual Insurance Company and Western Assurance Company (Respondents), Arbitrator ...

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Self-Employment Income Deducted Post-Accident – Yes or No?

December 18, 2018

In the recent Divisional Court decision released on December 7, 2018, Surani and Perth (File No.: 541/17), an application for judicial review was dismissed.  The ...

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The importance of knowing what to do with EI benefits for IRB purposes

December 11, 2018

In the LAT decision released July 18, 2018, C.M. and Aviva General Insurance (17-005910/AABS), the Applicant received a special award in the amount of 50% ...

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