The Automobile Injury Compensation Commission may not be able to reconsider a decision to pay accident benefits

The Court of Appeal upheld the Automobile Injury Compensation Appeal Commission’s (the “Commission”) decision holding that the Provincial Motor Vehicle Insurer was not entitled to terminate the Insured’s income replacement benefits.  Since the Commission had previously determined that the insured was entitled to insurance benefits, the Commission could not reconsider the decision several years later.

Shier v. Manitoba Public Insurance Co., [2008] M.J. No. 305, Manitoba Court of Appeal, M.A. Monnin, B.M. Hamilton and R.J.F. Chartier JJ.A., September 8, 2008

The Insured had been receiving income replacement indemnity (“IRI”) benefits since 1996 as a result of injuries she suffered in a 1994 car accident.  In 2006, a senior case manager with the Provincial Motor Vehicle Insurer reconsidered the 1996 decision after reviewing information that the Insurer received in 2000 from the Insured’s Canada Pension Plan (“CPP”) disability benefit file.  The case manager determined that the Insured had not been capable of holding employment at the time of the accident in light of a pre-existing disability and that she therefore did not qualify for income replacement benefits in accordance with the section 105 of the Manitoba Public Insurance Act (the “Act”).  This section provides that a victim who is regularly incapable, before the accident, of holding employment for any reason except age is not entitled to an income replacement indemnity or a retirement income.

The Commission allowed the Insured’s appeal from the case manager’s decision and ordered the Insurer to reinstate her IRI benefits from the date of their termination.  The Commission’s ruling was based on four separate grounds.  First, that there was no new information upon which the decision to terminate benefits had been made.  Second, that the Insurer had not exercised due diligence in obtaining the new information and, as a result, could not rely on this information to decide the Insured’s entitlement to benefits.  Third, the Insurer’s reconsideration of the 1996 decision was untimely because the Insurer had only 60 days from the date of the case manager’s decision to correct an error pursuant to Section 171(2) of the Act.  Fourth, the case manager for the Provincial Motor Vehicle Insurer had correctly considered section 105 in deciding the Insured’s entitlement to benefits in 1996.

The Insurer was granted leave to appeal the Commission’s decision on two questions of law, these being whether the Commission had erred in its interpretation of Section 171(2) of the Act or whether the Commission erred when it found that the principles set out in Palmer et al. v. The Queen, [1980] 1 S.C.R 759 apply to a Section 171(1) consideration of new information.

The Manitoba Court of Appeal noted that the Commission’s finding that there had been no error by the case manager in 1996 was sufficient on its own to resolve the dispute and that the appeal based on the approved questions of law was therefore moot.  The Court of Appeal nonetheless went on to exercise its discretion and address the issues raised by the approved questions.

On the first issue of law, the Court of Appeal found for the Insurer, finding that the Commission had erred in its interpretation of section 171(2) by reading in a 60-day time limit on the Insurer for correction of errors made by a case manager.  The Court of Appeal held that section 171(2) should be read to give the Insurer the authority to correct errors in certain circumstances provided that the decision being reconsidered is not the subject of review or appeal, as the words of that section clearly state.  On the second issue of law, the Court of Appeal found for the Commission and found that it had not erred in applying the principles for “fresh evidence” from R. v. Palmer, this being that the information must be relevant and decisive to the issue and the claimant must not be prejudiced by a lack of due diligence on the part of the Insurer in bringing the information forward, to the section 171(1) consideration.  The Court of Appeal noted that the Palmer principles offer logical and reasonable considerations when exercising discretion under section 171(1) to make a fresh decision because of new information, whether that exercise of discretion is by the Insurer in the first instance, or by the Commission on hearing of an appeal.

This case was originally summarized by Shanti Davies and originally edited by David W. Pilley.

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