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Insurance (Auto) - LAT Appeals (2). Wilson v. Intact Insurance Company
In Wilson v. Intact Insurance Company (Ont Div Ct, 2025) the Ontario Divisional Court allowed an insured's joint appeal/JR, this from a LAT SABS ruling that denied them catastrophic impairments benefit.
The court considered LAT reconsiderations, here in a SABS context:[16] In this context it is useful to consider Rule 18.2 of the Licence Appeal Tribunal Rules (“LAT Rules”), which sets out the criteria that must be met before a decision can be set aside on reconsideration. They are: (a) the Tribunal acted outside its jurisdiction or committed a material breach of procedural fairness; (b) the Tribunal made an error of law or fact that would likely have changed the result; or (c) new evidence not previously available that would likely have affected the result. If any of the criteria are met, the Tribunal can confirm, vary, or cancel the decision or order, or order a rehearing on all or part of the matter.[7] . Plante v. Economical Insurance Company
In Plante v. Economical Insurance Company (Ont Divisional Ct, 2024) the Ontario Court of Appeal allowed a LAT SABS appeal, here reviewing some history of the recent LAT 'takeover' from the Superior Court:[45] In 2016, the LAT was delegated the exclusive jurisdiction to resolve Accident Benefits disputes between insurers and claimants. The statutory jurisdiction of the LAT to resolve disputes involving statutory accident benefits arises pursuant to s. 280 of the Insurance Act, which provides as follows:280 (1) This section applies with respect to the resolution of disputes in respect of an insured person’s entitlement to statutory accident benefits or in respect of the amount of statutory accident benefits to which an insured person is entitled.
(2) The insured person or the insurer may apply to the Licence Appeal Tribunal to resolve a dispute described in subsection (1). [46] Section 280(4) of the Act makes clear that disputes under the SABS Schedule must be decided by the LAT. The Courts have no jurisdiction over these disputes except by way of an appeal on a question of law or by way of judicial review.
[47] The Court of Appeal in Stegenga v. Economical Mutual Insurance Company 2019 ONCA 615 (CanLII) noted that the purpose of assigning Accident Benefits disputes to the LAT was to, “[speed] up dispute resolution, in large part by providing an efficient, fair and accessible mechanism for resolving disputes” (para. 38).
[48] The LAT has broad remedial powers to address Accident Benefit disputes. As the court in Stegenga noted:Taken together, the words of s. 280(1) cover a wide array of disagreements connected in some way to the SABs to which an insured person was or is entitled. Viewed in the context of the purpose and history of the dispute resolution provisions, those words include disagreements about when the insurer’s obligation to provide SABs should be or should have been performed, and how the obligation to provide them should be or should have been performed. (Para. 45) [49] In executing its dispute resolution functions, the LAT “has all the powers that are necessary or expedient for carrying out its duties” (Licence Appeal Tribunal Act, 1999, s. 3(2)).
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