Notification of Incident Does Not Equate Notification Of Injury

Jakupovic v Intact Insurance Company, 2023 CanLii 122890 (CANLAT) 

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By: Krista Nasartschuk (Articled Clerk) 

The Ontario License Appeal Tribunal has determined that notification of a motor vehicle accident does not equate to a notification of injury for the purposes of applying for statutory accident benefits. 

Hussein Jakupovic, the Applicant, was involved in a motor vehicle accident on February 13, 2019. He notified Intact Insurance, the Respondent, of the accident on February 14, 2019, but did not indicate that he had sustained any injuries in the accident until December 2, 2019. 

Section 32(1) of the Statutory Accident Benefits Schedule (the Schedule) provides that applicants must inform the insurer of their intention to apply for statutory accident benefits no later than seven (7) days after the incident giving rise to entitlement. A delay in reporting this intention does not result in disentitlement; however, there is an onus on the applicant to provide a reasonable explanation for the delay pursuant to Section 32(2) of the Schedule. 

The Tribunal considered the following: 

Should the Respondent have made further inquiries about whether the Applicant was injured? The Tribunal found there was no clause in the Schedule or any other jurisprudence which would impose a duty upon the Insurer to ascertain whether an Applicant was injured and will be seeking accident benefits. 

Should the Respondent have provided the Applicant with information and forms for accident benefits upon being notified of the MVA? The Tribunal stated that the Respondent could not have provided the appropriate forms and information without being notified of the accident-related injuries. Further, the Tribunal notes that the Respondent acted quickly to provide the necessary forms and information upon provision of the relevant information. 

Can the Applicant plead ignorance? The Applicant knew to contact the Respondent regarding damage to the vehicle and he had access to his policy, therefore the Tribunal maintained that this was not a credible explanation worthy of belief. 

After considering the above, the Tribunal found that the Applicant’s explanations for the delay were not credible or worthy of belief. The application was dismissed without costs. 

Link: 2023 CanLII 122890 (ON LAT) | Jakupovic v Intact Insurance Company | CanLII

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