January 26, 2016

Don’t Miss Your Opportunities, Or You’ll Miss Your Benefits

Quadri v Aviva Canada Inc., FSCO A13-000527, Arbitrator Charles Matheson

 

Kasia Kosacka

Kasia Kosacka

MVC November 16, 2010. Aviva Canada Inc. (“Aviva”) terminated Ms. Quadri’s Income Replacement Benefits (“IRBs”) on August 5, 2011. The issues in dispute at the Preliminary Issue Hearing were whether Ms. Quadri could add IRBs to her Application for Arbitration, and whether she was statute barred from bringing the IRBs to Arbitration.

Ms. Quadri, who was originally represented by a law firm applied for Mediation of a series of Medical Benefits. She then requested that further Medical Benefits and IRBs be added to the Mediation on December 11, 2012. The Report of the Mediator was issued on December 13, 2012, and was silent on the IRBs issue.

Aviva argued that the IRB issue was withdrawn by Ms. Quadri’s new representative during the Mediation, and Ms. Quadri argued that the IRBs issue was inadvertently missed by the Mediator.

Arbitrator Matheson found that the issue was added correctly and discussed at the Mediation. However, there was no evidence that Ms. Quadri took steps to dispute the accuracy of the Report of Mediator. The Dispute Resolution Practice Code, requires a party who believes that the Report of the Mediator is not accurate, to notify the mediator and other parties in writing within 10 days of receiving the report. Further, the Application for Arbitration filed on January 23, 2013, detailed all the issues except for the IRBs issue. Arbitrator Matheson concluded that the IRBS issue was mediated, and withdrawn or otherwise dealt with during the Mediation process. As a result, Ms. Quadri could not add IRBs to the Arbitration.

Ms. Quadri’s new representatives then filed a second Application for Mediation to address the issue of IRBs on November 27, 2014, which resulted in a resumption of the Pre-Hearing on January 29, 2015. Arbitrator Matheson concluded that since Ms. Quadri received a clear and properly delivered denial of her IRBs on August 5, 2011, the limitation period of two years passed on August 5, 2013. Therefore, her subsequent Application for Mediation was filed too late, and she was statute barred from bringing the IRBs to Arbitration.

Implications

It is important to be aware of one’s options and resources when dealing with accident benefits. In this case, the Applicant missed her opportunity to dispute the Report of the Mediator, which meant giving up a benefit that she could have otherwise been entitled to. Similarly, it is important to note that the limitation period to dispute benefit denials is a rather rigid one, and if missed, will also likely lead to relinquishing one’s right to the benefit at issue. Finally, the importance of the Report of the Mediator itself should not be overlooked: one must look closely at the Report to ensure its accuracy, and to prevent situations like this from occurring.

 

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