17-000272 v T.T.

Dec 18, 2017

Adjudicator: Sandeep Johal

Issue:

Whether the applicant is entitled to repayment of the income replacement benefit paid to the respondent in the amount of $1,371.43 during the period from November 4, 2014 to November 27, 2014?

Results:

The applicant is entitled to the repayment. The respondent was employed during that period of time as evidenced by the Record of Employment provided to the insurer.  Further the applicant provided proper notice indicating that it was seeking repayment. Although the letters provided to the respondent were clearly not given within 12 months after the overpayment was made this time period does not apply if the amount was originally paid as a result of wilful misrepresentation. The respondent’s silence in this circumstance was a wilful misrepresentation.