RECONSIDERATION DECISION
Before: Brian Norris
Licence Appeal Tribunal File Number: 21-012541/AABS
Case Name: Mostafa Tazi v. Certas Home and Auto Insurance Company
Written Submissions by:
For the Applicant: Mostafa Tazi, Self-Represented
For the Respondent: Andrea R. Lim, Counsel
OVERVIEW
1This request for reconsideration was filed by Mostafa Tazi (“the Applicant”). It arises out of a decision, dated June 24, 2025 (“the decision”), where I found that the Applicant had not met his onus to demonstrate entitlement to income replacement benefits (“IRBs”) for the period from August 4, 2023 to-date and ongoing, and that he was unable to demonstrate that he is entitled to a weekly payment for IRBs that was above the amounts paid by Certas Home and Auto Insurance Company (“the Respondent”).
2The Applicant submits that I made an error of fact in the decision such that the Tribunal would likely have reached a different result had the error not been made.
RESULT
3The Applicant’s request for reconsideration is dismissed
BACKGROUND
4The Applicant was the driver of a vehicle which was struck from behind on a busy highway. The collision caused the Applicant’s vehicle to strike the vehicle in front of him. He was taken by ambulance to the hospital, discharged himself after a confrontation with staff, and met with his family physician the following day and was prescribed medication for neck and shoulder pain. He also developed an adjustment disorder, depression and anxiety following and as a result of the accident.
5He was unable to work as a result of the accident, for which the Respondent paid him IRBs. The Respondent sought to examine the Applicant to determine the Applicant’s ongoing entitlement to IRBs and it issued notices for insurer’s exam’s (“IEs”). The Applicant attended some of the IEs, but not all of them. As a result, the Respondent stopped payment of the Applicant’s IRBs, pursuant to section 37(7)(b) of the Schedule.
6The Applicant applied to the Tribunal to resolve the dispute of his entitlement to IRBs. The Respondent raised a preliminary issue that the Applicant should be barred from applying to the Tribunal, pursuant to section 55 of the Schedule, because he failed to attend the remaining IEs.
7In a preliminary issue hearing (“PIH”), the Tribunal found that the Applicant was not barred from proceeding with his claim. It concluded at paragraphs [13] through [16] that the Applicant was not statue-barred from proceeding with his claim because all the IE notices failed to comply with section 44 of the Schedule.
8The matter proceeded to a hearing in writing, where I issued the decision. At paragraph [12] of the decision, I noted that on May 31, 2024, the Respondent paid the Applicant IRBs for the period up to August 4, 2023. At paragraphs [25] through [35] of the decision, I found that the Applicant was not entitled to IRBs for any time thereafter.
9The dominant reason for finding that the Applicant was not entitled to IRBs for any time thereafter was because he tendered no medical evidence to support his claim for the period after August 4, 2023. I also noted that I found that the IE reports – the reports the Tribunal deemed to be as a result of deficient notices – outweighed the Applicant’s evidence. Lastly, I found that no award was payable because the Respondent’s refusal to pay was not unreasonable in light of the genuine belief by the Respondent that the Applicant was not complaint with section 44 of the Schedule.
ANALYSIS
10The grounds for a request for reconsideration are found in Rule 18.2 of the Licence Appeal Tribunal Rules 2023 (the “Rules”). To grant a request for reconsideration, the Tribunal must be satisfied that one or more of the following criteria are met:
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 such that the Tribunal would likely have reached a different result had the error not been made;
c) There is evidence that was not before the Tribunal when rendering its decision, could not have been obtained previously by the party now seeking to introduce it, and would likely have affected the result.
11Reconsideration is only warranted in cases where an adjudicator has made a significant legal or evidentiary mistake preventing a just outcome, where false evidence has been admitted, or where genuinely new and undiscoverable evidence comes to light after a hearing.
12The test for reconsideration under Rule 18.2 involves a high threshold. The reconsideration process is not an opportunity for a party to re-litigate its position where it disagrees with the Tribunal’s decision, or with the weight assigned to the evidence. The requestor must show how or why the decision falls into one of the categories in Rule 18.2.
13The Applicant submits that I relied on the IE reports that were from deficient notices and suggests that I should not have relied on them or given them less weight than I did.
14The Applicant also asked that I consider his academic qualifications and chronic pain, anxiety, and insomnia. He referred to his medical records addressed in the decision and sought equitable compensation in the form of support for reintegrating him into the labour market.
15The Applicant’s request for me to reconsider evidence in not a function of the reconsideration process. As noted, reconsideration is not an exercise of reweighing the evidence.
16The Applicant also complained that the Respondent handled his case inappropriately. He alleged that the Respondent sent people to his home at 8 p.m. and that they broke the door, insulted and threatened his family, and screamed in the building corridor. The Applicant tendered no evidence to support these allegations and the Respondent denied them.
17This request to address the Respondent’s behaviour is a new argument that I am unable to reconsider. The service of documents or the surveillance obtained by the Respondent was not at issue in the initial hearing. Thus, I find that it does not fall in any of the permitted grounds for reconsideration as outlined in section 18.2 of the Tribunal’s Rules.
18I will address the Applicant’s primary concern: whether it was an error of fact or law to consider the IE reports in the decision.
Was it an error of fact or law to rely on IE reports?
19I find that it was not an error of fact or law to rely on the IE reports such that the Tribunal would have reached a different decision had the error not been made.
20The Applicant’s position is that the IE reports should be barred or hold less weight because they were procured through deficient notices. From his submissions, I infer that the Applicant’s position is that I erred in fact or law by considering the reports, and that the Tribunal would have reached a different result had the error not been made.
21I dismiss the Applicant’s request regarding the IE reports on two grounds.
22First, if I were to not consider the IE reports, the Applicant would not have met his onus to demonstrate entitlement to IRBs because he provided no contemporaneous evidence to support his claim. Thus, the Applicant has not demonstrated that the tribunal would come to a different decision had the error not occurred. In paragraph [17] of the decision, I provided the test for IRBs and noted that the Applicant held the onus to demonstrate entitlement to the benefit. In paragraph [27] of the decision, I found that the Applicant provided no medical evidence that coincides with the period of IRBs he claims. I then went on to discuss the Applicant’s evidence and why it did not persuade me that he suffered a complete inability to carry on employment or self-employment for which he was reasonably suited by way of education, training, or experience. It was only after making that conclusion that I addressed the IE reports prepared by the Respondent and found they outweighed the Applicant’s evidence in paragraphs [32] through [35]. Accordingly, I find no error that the Tribunal would come to a different determination had it the error not occurred.
23Second, the Applicant’s argument about the admissibility of the IE reports is a new argument and is not permitted on reconsideration. Nevertheless. I do not agree that a person can attend an IE, but later claim that the notice was improper and have the report struck. It would be wrong to permit an insured person to attend an IE and participate in the examination, but later claim that the report from the assessment is void due to improper notice. I also note that the Respondent’s suspension of IRBs after August 4, 2023 stems from the Applicant’s failure to attend IEs which post-date the PIH and are unrelated to the IE reports mentioned in the decision.
24The notice related to the current denial, dated July 19, 2023, is compliant with section 44 of the Schedule. The notice meets all the requirements outlined in section 44(5) of the Schedule, including the medical and other reasons of assessing ongoing entitlement after 104 weeks buy determining the status of his recovery from his soft tissue injuries and obtain an opinion on whether he suffers a complete inability to engage in employment or self-employment. For some of the assessments, the notices state his attendance is virtual, others are in-person and transportation will be provided; the assessors are listed, including all their specialties, and the day, time and location are listed for each assessment.
25Overall, the decision was grounded in the finding that the Applicant did not meet his onus to demonstrate that he suffered a complete inability to engage in employment or self-employment for which he is reasonably suited by way of education, training, or experience. Accordingly, I find no error of fact or law in considering the IE reports, because it would not change the outcome of the decision.
CONCLUSION & ORDER
26The Applicant has not demonstrated that the decision contains an error of fact or law such that the Tribunal would come to a different result had the error not occurred.
27As a result, the reconsideration is dismissed.
Brian Norris Associate Chair Tribunals Ontario – Licence Appeal Tribunal
Released: October 22, 2025