PRELIMINARY ISSUE HEARING DECISION AND ORDER
Licence Appeal Tribunal File Number: 25-000446/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:
Ali Vahdati
Applicant
and
Allstate Insurance Company of Canada
Respondent
ADJUDICATOR:
Lisa Holland
APPEARANCES:
For the Applicant:
Adesina John, Paralegal
For the Respondent:
Greg Specht, Counsel
Heard:
By Way of Written Submissions
OVERVIEW
1Ali Vahdati (the “applicant”) was involved in an automobile accident on March 19, 2020 and sought benefits pursuant to the Statutory Accident Benefits Schedule- Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by Allstate Insurance Company of Canada (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 issue to be decided is:
i. Is the applicant barred from proceeding to a hearing by the doctrine of res judicata because the issue of applicability of the Minor Injury Guideline (“MIG”) was already decided in prior LAT decision of 22-009954/AABS?
RESULT
3The applicant was found to be within the MIG in the previous decision dated October 18, 2024, and he is barred from proceeding with his application before the Tribunal because the doctrine of res judicata applies.
ANALYSIS
Background
4The applicant was involved in an accident on March 19, 2020, and filed an application with the Tribunal bearing file no. 22-009954/AABS. In a decision dated October 18, 2024, the Tribunal determined that the applicant remained within the MIG, and that he was not entitled to the treatment plans for physiotherapy services beyond the MIG limits.
5The applicant filed a request for reconsideration of the 2024 decision, and in reconsideration decision dated February 3, 2025, the original decision that the applicant remains in the MIG was upheld. In the reconsideration decision, the Tribunal decided that there was no material breach of procedural fairness by excluding a s.25 psychological report dated July 26, 2023, because the report was not served within the production deadlines set out in the Case Conference Report and Order.
6The applicant subsequently submitted additional treatment plans, which were denied by the respondent on the basis that the applicant remains within the MIG. The applicant then applied to the Tribunal for resolution in the present case. This second application again seeks a determination that the applicant be removed from the MIG and is entitled to payment for six new treatment plans, an award and interest.
7At the case conference held on April 15, 2025, the respondent raised the preliminary issue that the doctrine of res judicata applies to the current application regarding the issue of whether the applicant’s injuries fall under the MIG.
Preliminary Issue: Res Judicata and Tribunal File 22-009954/AABS
8I find that that the doctrine of res judicata applies.
9The respondent submits the doctrine of res judicata applies to this application, as the Tribunal previously determined that the applicant suffered minor injuries as a result of this accident which were treatable within the limits of the MIG. As noted above, the 2024 decision was upheld on reconsideration.
10The applicant submits that res judicata does not apply to his claim for benefits because the previous decision is not final because it did not address the six new treatment plans in dispute, and these plans are different questions. However, the applicant does not explain why res judicata does not apply to the issue of whether his injuries fall within the MIG, since the previous decision has already decided that question. In addition, if the applicant’s injuries are within the MIG, it is not necessary to consider the disputed treatment plans as the $3,500 MIG funding limit has been exhausted.
11The doctrine of res judicata prevents a party from relitigating an issue that has already been decided. Three preconditions must be established before the adjudicator can determine whether to exercise discretion to apply the doctrine of res judicata, or more specifically issue estoppel, as set out by the Supreme Court of Canada in Danyluk v. Ainsworth Technologies Inc., 2001 SCC 44 at para.25:
i. that the same question has been decided;
ii. that the judicial decision which is said to create the estoppel was final; and,
iii. that the parties to the judicial decision or their privies were the same persons as the parties to the proceedings in which the estoppel is raised or their privies.
12I am satisfied that these preconditions have been met and that the doctrine of res judicata applies to this application. The prior decision was made on the merits and found that the applicant sustained injuries within the MIG. Although the applicant argues he has new medical evidence, (which I will address below), I find that the issue of MIG has already been decided. Further, the 2024 decision was upheld on reconsideration and was a final decision. I find that the parties are the same as in the previous application.
13However, the applicant further argues that if res judicata applies, it should be waived in this instance. I will now turn to consider this argument.
Waiver of Res Judicata and new evidence
14I find that the applicant has not established that res judicata should be waived in this case.
15The applicant argues that if res judicata does apply, it should be waived, since fresh, new evidence, previously unavailable, conclusively impeaches the original result, and fairness dictates that the original result should not be binding in the new context.
16As set out in Toronto (City) v. CUPE Local 79, 2003 SCC 63 at para. 52, res judicata can be waived in the following situations:
a) The first proceeding is tainted by fraud or dishonesty;
b) Fresh, new, evidence is submitted that was previously unavailable that would conclusively impeach the original results; or
c) When fairness dictates that the original result should not be binding in the new context.
17The applicant does not argue the first proceeding was tainted by fraud or dishonesty.
There is no fresh, new evidence
18I find that there is no fresh, new evidence in this case.
19The applicant submits that a psychological report dated July 26, 2023, was available at the prior hearing, but it was excluded from evidence. The applicant relies on the six new treatment plans in dispute. The applicant further submits that the treatment plans constitute new evidence, but he does not explain how new treatment plans would impeach the original result.
20The respondent submits that res judicata applies, as the applicant was already found to be within the treatment limits of the MIG and is not entitled to any additional treatment expenses. The respondent further submits that the applicant has not produced new evidence that was unavailable at the time of the previous decision in support of a psychological impairment to warrant his removal from the MIG.
21I find that the new evidence submitted by the applicant does not impeach the original results.
22I find that the applicant’s psychological symptoms were known to the applicant at the time of the previous decision. The applicant had the opportunity to address his psychological condition at the first hearing.
23I am not satisfied that the new treatment plans are sufficient to represent new evidence that was previously unavailable and would conclusively impeach the original results to waive res judicata. In addition to the fact that the new treatment plans were available prior to the 2024 decision, (the plans are dated in May 2021, July 2021, February 2022, May 2023 and July 2023), the applicant does not explain what new medical evidence support his removal from the MIG funding limit to consider his entitlement to these plans. Given the foregoing, res judicata would operate to bar this evidence in relation to the MIG. Consequently, the applicant remains bound by the previous determination in Tribunal file 22-009954/AABS, and is subject to treatment within the MIG.
24I find that the applicant is barred by operation of the doctrine of res judicata from re-litigating the issue of whether his accident-related injuries fall under the MIG and that doctrine should not be waived in the circumstances.
ORDER
25I find that the applicant is barred from proceeding with his application pursuant to the doctrine of res judicata.
26The application is dismissed and the substantive hearing is vacated.
Released: July 11, 2025
Lisa Holland
Adjudicator