Canadian Underwriter

If injury is suspected to be deliberate, claimant does not have option to go to Appeal Commission to challenge denial of injury claim

September 30, 2010   by

Print this page Share

If an auto injury claim in Manitoba is denied on the basis that the damage was caused by a deliberate or willful act, a claimant does not have the option to have the Automobile Injury Compensation Appeal Commission (AICAC) review the decision, the Manitoba Appeal Court has found.

Paule-Michelle Constantin reported to Manitoba Public Insurance (MPI) that she was transporting a propane stove on the back seat of her vehicle on Apr. 1, 2005. While seated in the driver’s seat and smoking a lit cigarette, she turned around to re-position the stove and was suddenly enveloped in fire and was thrown from the vehicle. She made a claim for her burn injuries. Initially MPI denied the claim on the basis that Constantin’s injuries were not caused by the automobile or use of the automobile. Constantin appealed to the AICAC, which found in her favour, and she received compensation for her burn injuries. But then MPI found fresh evidence suggesting the incident that gave rise to her injuries was not accidental, but rather willfully caused in an attempted suicide.

Constantin sought to appeal MPI’s second denial of the claim to the AICAC, but MPI said the decision could only be appealed through the courts. The court determined the legislation that defines the claimant’s options for appealing MPI’s decision contains a specific “notwithstanding” exclusion. This would prevent appeals from going to the AICAC if the benefits were denied on the basis that they were not ‘accidents,’, but rather willfully caused. •