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The Court of Appeal affirmed that the Licence Appeal Tribunal has exclusive jurisdiction over statutory accident benefits disputes, barring class actions against insurers.
This appeal concerned proposed class actions against auto insurers for improperly deducting HST from statutory accident benefits (SABs) and against the Financial Services Commission of Ontario (FSCO) for alleged regulatory failures.
The motion judge had dismissed claims against insurers due to the exclusive jurisdiction of the Licence Appeal Tribunal (LAT) under s. 280 of the Insurance Act, but allowed claims against FSCO to proceed.
The Court of Appeal upheld this decision, confirming the LAT's exclusive jurisdiction over SAB disputes and affirming the court's jurisdiction over tort claims against the regulator.
The court also refused leave to appeal the motion judge's costs order, finding it within his discretion.
The two-year limitation period for disputing a denial of statutory accident benefits is subject to the rule of discoverability.
A pedestrian struck by a vehicle in 2008 received statutory accident benefits for attendant care and housekeeping until the insurer terminated them in 2010.
In 2015, after receiving a catastrophic impairment designation, the claimant reapplied for benefits.
The Tribunal and Divisional Court found the claim was out of time based on a two-year limitation period.
The Court of Appeal allowed the appeal, finding that the limitation period was subject to the rule of discoverability and was not a hard limitation period.
The court held that applying a hard limitation period would be contrary to the consumer protection purposes of the Statutory Accident Benefits Schedule and would produce an absurd result by barring claims before the claimant was eligible to make them.
The court refused to reconstitute as the Divisional Court to consolidate separate appeals.
The moving party sought either to have the Court of Appeal reconstitute itself as a panel of the Divisional Court to hear his appeal immediately after the appellant's appeal, or to be granted leave to intervene as a party in the appellant's appeal.
Both the moving party and the appellant were injured in motor vehicle accidents and had their statutory accident benefits claims denied.
The moving party argued that both appeals raised the same or similar issues regarding the application of the two-year limitation period for disputing the refusal of statutory accident benefits.
The court dismissed both requests, finding that allowing the moving party to bypass the Divisional Court would be improper absent compelling reasons, and that efficiency alone was insufficient justification for such an extraordinary step.
Bad faith claims regarding statutory accident benefits fall within the Licence Appeal Tribunal's exclusive jurisdiction.
The appellant, seriously injured in a motor vehicle accident, sued her insurer for bad faith in handling her statutory accident benefits (SABs) claim, seeking punitive and exemplary damages.
The insurer had failed for approximately three years to advise the appellant or her parents that her injuries qualified as a catastrophic impairment or to inform them of available benefits.
The motion judge struck the statement of claim, finding that the Licence Appeal Tribunal (LAT) had exclusive jurisdiction under section 280 of the Insurance Act.
The Court of Appeal upheld this decision, holding that the dispute resolution provisions of the Insurance Act apply broadly to disputes concerning SABs entitlement and administration, regardless of whether the claim is characterized as one for bad faith.
Venue transfer granted from Barrie to Toronto as the action had no connection to Barrie.
The defendant brought a motion to transfer a personal injury action arising from a motor vehicle collision from Barrie to Toronto.
The collision occurred in Toronto, and all parties, counsel, and potential witnesses, including medical professionals, were located in or near Toronto.
The plaintiff did not respond to the motion.
The court applied the factors under Rule 13.1.02 of the Rules of Civil Procedure and concluded that Toronto was a substantially better venue, as there was no connection between the action and Barrie.
The motion to transfer was granted.
SABS limitation period is a hard deadline triggered by benefit denial, not subject to discoverability.
The applicant sought judicial review of a Licence Appeal Tribunal decision which found her claim for attendant care and housekeeping benefits was statute-barred.
The applicant argued that the limitation period should not begin to run until she was found to be catastrophically impaired, relying on the doctrine of discoverability.
The Divisional Court dismissed the application, holding that the limitation period under the Statutory Accident Benefits Schedule is a 'hard' limitation period triggered by the insurer's clear and unequivocal refusal to pay the benefit, regardless of whether the claimant is aware they have a claim at that time.
Statement of claim for bad faith in accident benefits administration struck for falling within LAT's exclusive jurisdiction.
The plaintiff sued her insurer for bad faith, negligence, and fraud in the administration of her statutory accident benefits claim following a motor vehicle accident.
The defendant insurer brought a Rule 21 motion to strike the statement of claim, arguing the Licence Appeal Tribunal (LAT) had exclusive jurisdiction under section 280 of the Insurance Act.
The court agreed, finding that the essential character of the dispute concerned the denial of accident benefits, which falls within the exclusive jurisdiction of the LAT regardless of how the claim is legally characterized.
The statement of claim was struck without leave to amend.
Wrong reasons did not stop a clear benefits denial from triggering limitations.
The appellant challenged summary judgment dismissing her statutory accident benefits action for non-earner benefits as out of time.
The court held that a clear and unequivocal denial of benefits triggered the two-year limitation period, even though the insurer gave an incorrect legal reason for ineligibility.
The limitation period ran from the initial refusal of non-earner benefits, not from the later termination of income replacement benefits.
The court further held that neither the Insurance Act nor the SABS required the insurer to give renewed notice of a possible entitlement to a previously denied benefit upon termination of another benefit.
The appeal was dismissed with costs.
Physical and psychological impairments may be combined to meet the catastrophic impairment threshold under SABS.
The appellant suffered severe physical and psychological injuries, including a leg amputation and clinical depression, in a motor vehicle accident.
He sought enhanced statutory accident benefits, arguing he was catastrophically impaired.
The trial judge held that physical and psychological impairments could not be combined under section 2(1.1)(f) of the Statutory Accident Benefits Schedule to meet the 55 per cent whole person impairment threshold.
The Court of Appeal reversed this decision, finding that the language of the Schedule, the purpose of the American Medical Association's Guides, and the goals of the statutory scheme permit the combination of physical and psychiatric impairments to determine catastrophic impairment.