Citation and Parties
Licence Appeal Tribunal File Number: 23-015303/AABS
In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.
Between:
Leona Spencer
Applicant
and
Zenith Insurance Company
Respondent
PRELIMINARY ISSUE HEARING DECISION AND ORDER
ADJUDICATOR:
Kate Grieves
APPEARANCES:
For the Applicant:
Michael R. Switzer, Counsel
For the Respondent:
Jennifer McGlashan, Counsel
Heard:
By Way of Written Submissions
OVERVIEW
1Leona Spencer (the “applicant”) was involved in an incident on or around September 16, 2020, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (“Schedule”). The applicant was denied benefits by Zenith Insurance Company (the “respondent”) and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
PRELIMINARY ISSUE IN DISPUTE
2The preliminary issues are:
i. Was the applicant was involved in an “accident” as defined in section 3(1) of the Schedule?
ii. Is the applicant barred from proceeding to a hearing as the applicant failed to notify the respondent of the circumstances giving rise to a claim for benefits no later than the seventh day after the circumstances arose or as soon as practicable after that day?
iii. Is the applicant barred from proceeding with the claim for benefits as the applicant failed to submit the application for benefits (OCF-1) within the time prescribed by the Schedule?
RESULT
3The applicant was involved in an “accident” as defined in s. 3(1) of the Schedule.
4The applicant is barred from proceeding to a hearing pursuant to section 55(1) as she failed to notify the respondent of the circumstances giving rise to a claim for benefits within the timelines prescribed in section 32(1) of the Schedule.
5Section 32(5) does not apply.
ANALYSIS
Background
6On or around September 16, 2020, the applicant was walking her dog along a sidewalk when