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December 2016

Featured Case Study

Raho Mohamud v. Old Republic Insurance Company

Garett Harper
Garett Harper

By Garett Harper

The Licence Appeal Tribunal ("LAT") acted quickly and efficiently to correct an error that was contained in the decision of 16-000179 - Raho Mohamud v. Old Republic Insurance Company that was released by the tribunal earlier this month. This matter, which proceeded by way of a written hearing, dealt with entitlement to pre-104 week IRBs.

In the underlying decision, the LAT determined that the insurer’s determination to discontinue the Applicant’s entitlement to pre-104 week IRBs was incorrect. However, not only were the applicant’s benefits ordered to be reinstated, it was also ordered that the applicant was entitled to receive these benefits to the future defined date of May 21, 2017 (the two year anniversary of the underlying accident).

As a result of this decision, the insurer requested a reconsideration of the LAT’s decision pursuant to Rule 18 of the Licence Appeal Tribunal’s Rules of Practice and Procedures. Specifically, the insurer requested a variation of the Order to remove the obligation to pay IRBs into the future. The LAT ultimately agreed with the insurer and ruled that the original order should be varied.

 In coming to this decision, the LAT stated that the order which fixed an end-date for the applicant’s entitlement to IRBs was incorrect. Specifically, the LAT agreed with the insurer and stated that the order harmed the insurer’s ability to adjust the applicant’s claim in the event new facts that are material to the applicant’s entitlement to IRBs emerge. The LAT stated the following:

"An amended order is able to both deal with the previous error while still preserving the applicant’s right to the ongoing IRB benefit until such time [the applicant] is no longer eligible under the Schedule."

After considering the positions of the applicant and the insurer, the order was amended.

It is encouraging to note that this matter proceeded from the application stage to the conclusion of the appeal process in a period of only 6 months. Furthermore, the fact that the LAT granted a request for reconsideration highlights its commitment to developing good jurisprudence and ensuring its decisions are correct.

We continue to monitor decisions emerging from the LAT with great interest. Stay tuned for further updates!

Read the original LAT Decision and the Reconsideration Decision.


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