D.M. v. Royal Sun Alliance Insurance, 2020 CanLII 27389

Tribunals Ontario Safety, Licensing Appeals and Standards Division

Box 250 Toronto ON M7A 1N3 Tel: 1-844-242-0608 Fax: 416-327-6379 Website: www.slasto-tsapno.gov.on.ca

Tribunaux décisionnels Ontario Division de la sécurité des appels en matière de permis et des normes

Boîte no 250 Toronto ON M7A 1N3 Tél. : 1-844-242-0608 Téléc. : 416-327-6379 Site Web : www.slasto-tsapno.gov.on.ca

RECONSIDERATION DECISION

Before: Terry Hunter, Vice Chair

Date: April 8, 2020

File: 18-003146/AABS

Case Name: D.M. v. Royal Sun Alliance Insurance

Written Submissions By:

For the Applicant: Stanley Razenberg, Legal Counsel

For the Respondent: Paul W. Belanger, Legal Counsel

Introduction

1The applicant requests a reconsideration of the Order of Vice Chair Terry Hunter dated January 7, 2019. The applicant requests the Order of January 7, 2019 be set aside and a Reconsideration Order made enforcing the settlement between the applicant, [D.M.] and the respondent, Royal Sun Alliance in accord with the settlement reached between the parties.

2Pursuant to her authority under s. 17(2) of the Adjudicative Tribunals Accountability, Governance and Appointments Act, 2009, S.O. 2009, c. 33, Sched. 5, the Executive Chair delegated to me her responsibility to decide this reconsideration request.

3For the reasons that follow the applicant’s request for reconsideration is granted.

The Facts

4The application of [D.M.] arises out of injuries he sustained in a motor vehicle accident on January 19, 2016. The applicant applied for and received statutory accident benefits from the respondent, Royal Sun Alliance pursuant to the Statutory Accident benefits Schedule. The respondent denied certain accident benefits, and the applicant filed an application with the Licence Appeal Tribunal on April 11, 2018.

5The parties proceeded to a case conference on August 8, 2019. The applicant confirmed they were proceeding with the claim for the outstanding balance on a treatment plan and an award, commonly referred to as a special award.

6The parties had settlement discussions resulting in agreement for $4,500.00 to settle the applicant’s claim. The parties did not agree on how the funds were to be apportioned.

7The applicant brought a motion returnable November 28, 2018 before me to enforce a partial settlement between the parties, or in the alternative to set a date for a hearing to determine the remaining issues in the application.

8The motion order dated January 29, 2019 denied the motion to enforce the partial settlement. The order allowed the request to set a date for a hearing. On February 19, 2019 the applicant made a request for a reconsideration of the order on the basis the Tribunal made an error of law or fact such that the Tribunal would have reached a different result had the error not been made.

9In paragraph [10] of the Motion order of January 29, 2019 I found Section 280(2) of the Insurance Act provided the Tribunal with the authority to determine entitlement to benefits or quantum of benefits. I concluded I did not have authority to apply principles of contract law to determine whether a settlement has been reached.

10I was wrong in coming to that conclusion. The Court of Appeal in Stegenga¹ held that s. 280 of the Insurance Act embraces a more robust jurisdiction than deciding entitlement and the extent of that entitlement. The issue as to whether a settlement has been reached clearly was before me and declining to decide that issue is a significant error of law pursuant to Rule 18.2(b) of the Tribunal’s Common Rules of Practice and Procedure.

11Riggs Estate v. Intact² held that Stegenga confirmed that the provisions of the Insurance Act constitute a complete code for the resolution of disputes in respect of an insured persons entitlement to SABs or the amounts of those benefits.

12The Court found in Riggs that LAT has exclusive jurisdiction to determine whether a binding settlement was reached.

13I am aware the parties did not have the benefit of these decisions when they made their submissions on the reconsideration request. I will grant the parties 30 days from the release of this decision to comment on these cases. The parties may make submissions limited to 5 pages.

CONCLUSION

13This request for reconsideration is granted subject to the receipt of further submissions of the parties.

14Once submissions are reviewed if my decision is unchanged, I will determine the motion on the materials the parties have filed.

Footnotes

1. 1Stegenga v. Economical Mutual Insurance Company, 2019 ONCA 615
2. 2Riggs Estate v. Intact, 2019 ONSC 6846