CITATION: Huynh v. Security National, 2026 ONSC 4759
DIVISIONAL COURT FILE NO.: 441/25
DATE: 20260817
ONTARIO
SUPERIOR COURT OF JUSTICE
DIVISIONAL COURT
SACHS, O’BRIEN, AND KAUFMAN JJ
BETWEEN:
TAN TAI HUYNH
Appellant
– and –
SECURITY NATIONAL INSURANCE
company
Respondent
Steven Sieger, for the Appellant
Crystal Law and Rocky Wang, for the
Respondent
HEARD on January 29, 2026 via videoconference in Toronto
reasons for Decision
[1] The panel hearing this appeal was comprised of Sachs J., O’Brien J. and Kaufman J. Sachs J. retired on April 1, 2026. She had agreed to the reasons as set out below, but due to error, the reasons were not released prior to or within 90 days of her retirement. Under s. 123(3) of the Courts of Justice Act, R.S.O. 1990, c. C.43, where a judge has commenced a hearing together with other judges and is for any reason unable to participate in giving the decision of the Court, the remaining judges may complete the hearing and give the decision of the Court unless the remaining judges are equally divided.
[2] We are not divided and we are unanimous in this decision. These are the reasons of the Court.
Overview
[3] The appellant injured himself in January 2022 when he fell while moving boxes out of his running car. Having fractured his elbow in a manner that required surgery, he sought statutory accident benefits from his insurer, the respondent. The respondent denied benefits because of its view that the appellant did not suffer an “accident” within the meaning of the Statutory Accident Benefits Schedule, Reg. 34/10 (SABS). The matter proceeded to a hearing before the Licence Appeal Tribunal. At the Tribunal, the appellant submitted he had been in an “accident” and claimed income replacement benefits, payments for services under the treatment plans in dispute, interest, and an award under s. 10 of Automobile Insurance, R.R.O. 1990, Reg. 664.
[4] The Tribunal agreed that the appellant had been in an accident but was not satisfied the appellant had met his burden of establishing an entitlement to the benefits he sought. The hearing was addressed in-writing. The appellant only provided an x-ray report, a statutory form completed by a chiropractor, and the transcript of his examination under oath. The adjudicator found there was no compelling medical evidence establishing the extent or duration of the appellant’s accident-related impairments. He also did not provide sufficient details of the treatment plans to show they were reasonable and necessary. As no benefits were payable, neither interest nor an award under s. 10 of Reg. 664 were owed.
[5] The appellant sought reconsideration of the Tribunal decision. The request for reconsideration was determined by the same adjudicator. She found that the high threshold for allowing a request for reconsideration had not been met. According to the adjudicator, the appellant was asking her to re-weigh the evidence and did not explain how his arguments met the grounds for reconsideration under the Tribunal’s rules.
[6] The appellant now appeals the decision on the request for reconsideration to this court. His primary submission is that the adjudicator erred by rejecting his uncontradicted medical evidence, even though he provided the statutorily required form to claim benefits. Although the insurer took the position he was not in an accident, it did not contest that his injuries otherwise met the test for benefits under the SABS. The appellant raises a second issue, submitting that it was a breach of procedural fairness for the adjudicator to reconsider her own decision.
[7] The appellant also brought a motion for fresh evidence. He seeks to admit evidence of (1) an insurer examination report dated August 8, 2025 in relation to a treatment plan completed on January 14, 2025; and (2) the adjuster’s log notes, which he says he did not obtain in time to submit to the adjudicator.
[8] For the following reasons, I would dismiss both the motion to introduce fresh evidence and the appeal.
Does the proposed fresh evidence meet the R. v. Palmer test?
[9] The fresh evidence does not meet the test in R. v. Palmer, [1980] 1. S.C.R. 759. There is no need to review all the criteria in the Palmer test because the evidence fails on the requirement that the evidence bear on a decisive or potentially decisive issue.
[10] The insurer report was prepared in response to a new treatment plan submitted by the appellant that was not the subject of the adjudicator’s decision. The appellant relies on the insurer’s report because, he says, the doctor acknowledges the appellant’s previous treatment (for which he was denied benefits) was appropriate. He relies on the adjuster’s log notes mostly because the notes demonstrate the insurer set aside a reserve for medical and rehabilitation benefits. He submits these documents support his position that his injury entitled him to the benefits he sought before the adjudicator.
[11] The problem is that the evidence is relevant only to factual determinations. An appeal from a decision of the Tribunal is limited to questions of law: Licence Appeal Tribunal Act, 1999, S.O. 1999, c. 12, Sched. G, s. 11(3). It is not the court’s role to weigh the evidence to determine the degree of the appellant’s injuries nor the extent to which his treatment plans were appropriate. It was open to the appellant to bring an application for judicial review of the Tribunal’s decision: Yatar v. TD Insurance Meloche Monnex, 2024 SCC 8, 489 D.L.R. (4th) 191, at para. 48. Had he done so, and although it is rare for a reviewing court to intervene in a tribunal’s factual findings, it would have been open to the court to review the adjudicator’s factual determinations. Having not brought an application for judicial review, the court’s role is limited to determining whether the adjudicator erred in law. The proposed new evidence is irrelevant to that determination and therefore should not be admitted.
Did the Tribunal err in law by finding the appellant’s evidence did not meet the burden of proof?
[12] The appellant submits the adjudicator erred in finding he was not entitled to the income replacement and treatment plan benefits he sought in the face of his uncontested medical evidence.
[13] To understand the appellant’s submission, it is necessary to explain the background leading to the evidence he submitted. As set out above, his evidence was limited to a form completed by his chiropractor, an x-ray, and a transcript of his testimony during examinations by the insurer.
[14] The SABS is consumer protection legislation. It is designed “to reduce economic dislocation and hardship for victims of motor vehicle accidents”: Hussein v. Intact Insurance Company, 2025 ONSC 842 (Div. Ct.), at para. 4. Pursuant to this mandate, the SABS provides standardized forms for a claimant’s medical practitioner to complete to establish the claimant’s injuries and potential entitlement to benefits: SABS, s. 36.
[15] In this case, the appellant’s chiropractor filled out the Disability Certificate form, which is called an OCF-3. The form requires the health practitioner to answer various questions using “yes,” “no,” or “N/A” tick boxes, with some requests for further explanation. The form was submitted to the respondent, which denied benefits, but not because it was dissatisfied with the medical evidence. The insurer is not required to accept the information in the forms at face value, but in this case the insurer did not deny benefits because of insufficient information. The insurer instead denied the benefits because it said there was no qualifying accident. Before the Tribunal, the insurer’s position rested entirely on its submission that the appellant had not suffered an accident within the meaning of the SABS.
[16] The question, therefore, is whether the adjudicator was required to treat the appellant’s evidence as sufficient in the circumstances of this case. I conclude she was not. It is within the discretion of the adjudicator to weigh the evidence and determine whether the applicant has met his burden of proof. As Lococo J. stated in Dooman v. TD Insurance Co., 2025 ONSC 184 (Div. Ct.), at para. 36:
The Tribunal was free to accept all, none, or some of the hearing evidence, including any expert evidence. While a trier of fact is obliged to consider all the evidence before it, it [is] not required to accept all of a medical expert’s evidence merely because there is no contrary expert testimony tendered on behalf of the other party.
[17] Regardless of the insurer’s position, the appellant was required to demonstrate to the Tribunal that he met the legal test for receiving income replacement benefits. As the adjudicator states, that test arises from s. 5(1) of the SABS and requires the applicant to demonstrate that, within 104 weeks of the accident, they suffered a substantial inability to perform the essential tasks of their employment. At para. 37 of her initial reasons, the adjudicator states: “The applicant must identify the essential tasks of their employment, which tasks they are unable to perform and to what extent they are unable to perform them.”
[18] Even if an adjudicator may be required, in some circumstances, to accept the OCF-3 and other forms as sufficient evidence (which I do not need to decide), she was not required to do so here. The OCF-3 was completed only by ticking boxes and without providing any extra detail in any “please explain” boxes. Although the chiropractor wrote in several places “See GP notes” or “as per GP,” no GP notes were attached. The appellant also attended an insurer’s examination where he stated he could not lift anything heavy, but he did not provide any details of the essential tasks of his employment and the degree to which he was unable to perform them. Further, with respect to the appellant’s claim for payment for specific treatment plans, he failed to submit the statutory forms (OCF-18s) to the adjudicator at all.
[19] Another way the appellant articulated the argument about his evidence was that the Tribunal breached procedural fairness by dismissing his claim for benefits, even though the insurer had not taken issue with his evidence. I do not find this submission persuasive. The Tribunal held a case conference with the parties before the in-writing hearing was scheduled. The case conference report and order specified that the hearing would include the determination of the preliminary issue as to whether the appellant was involved in an “accident,” but also the substantive issues regarding his entitlement to benefits. It listed, as issues to be decided, each of the benefits he claimed. It also provided a list of documents the appellant had to provide the respondent, which included, for example, clinical notes from all treating physicians, hospital records, his updated OHIP records, and his records from his family doctor. The appellant, therefore, was aware that, despite the insurer’s position, the adjudicator would be determining the benefit entitlement issues and expected a detailed medical record.
[20] In the end, there was no legal error in the adjudicator’s finding that the appellant had failed to meet his burden of proof. This ground of appeal is dismissed.
Was it a breach of procedural fairness for the same adjudicator to determine the request for reconsideration?
[21] The appellant’s other ground of appeal, that it was a breach of procedural fairness for the same adjudicator to determine the request for reconsideration, must also fail. Rule 18.1 of the Tribunal’s Rules expressly provides that a request for reconsideration “may be heard by the same member whose decision is the subject of the request, or by another member.” This court has repeatedly found in the administrative context that it is not a breach of procedural fairness for a tribunal member to reconsider his or her own decision: Warren v. Ontario (Licence Appeal Tribunal), 2022 ONSC 3741 (Div. Ct.), 25 C.C.L.I (6th) 33, at para. 19; Taucar v. Human Rights Tribunal of Ontario, 2017 ONSC 2604 (Div. Ct.), at paras. 90-99; Decosse v. Miklos, 2019 ONSC 6034 (Div. Ct.), at paras. 25-26. The practice of having members reconsider their own decisions contributes to efficiency and expeditiousness, since the member is already familiar with the file. Further, as this court stated in Warren, at para. 22: “Reconsideration under the LAT Rules is not a hearing de novo or an appeal: it is a corrective mechanism which allows an adjudicator to correct overriding errors or fundamental evidentiary concerns.”
[22] The appellant has not shown a breach of procedural fairness with the application of the Tribunal’s rule, either generally or in the circumstances of this case. Contrary to his submission, the adjudicator did engage with his arguments in the reconsideration decision. She was fully aware of his claim that she was required to accept uncontradicted medical evidence. However, she rejected this argument, stating at para. 12 of her reasons that she was “under no obligation to accept at face value the findings or opinions of the medical professionals” put before her, even if there is no contradictory evidence. She also generally rejected the appellant’s arguments as a request to reweigh evidence, which is not the function of a reconsideration. There was no unfairness in the way the adjudicator responded to the appellant’s request for reconsideration.
Disposition
[23] The appeal is dismissed. In accordance with the agreement of the parties, the appellant shall pay the respondent costs of $5,000 all-inclusive.
_______________________________ O’Brien J.
_______________________________
Kaufman J
Released: August 17, 2026
CITATION: Huynh v. Security National, 2026 ONSC 4759
DIVISIONAL COURT FILE NO.: 441/25
DATE: 20260817
ONTARIO
SUPERIOR COURT OF JUSTICE
SACHS, O’BRIEN, AND KAUFMAN JJ
BETWEEN:
TAN TAI HUYNH
Appellant
– and –
SECURITY NATIONAL INSURANCE
company
Respondent
REASONS FOR DECISION
O’Brien, J.
Released: August 17, 2026