Julie Cunningham v. Certas Home and Auto Insurance Company, 2026 CanLII 37014

Reconsideration Decision

Citation: Cunningham v. Certas Home and Auto Insurance Company, 2026 CanLII 37014 Licence Appeal Tribunal File Number: 24-012392/AABS Case Name: Julie Cunningham v. Certas Home and Auto Insurance Company

Before: Craig Mazerolle, Vice-Chair

Written Submissions by: For the Applicant: Julie Cunningham, Applicant For the Respondent: Brittanny Tinslay, Counsel

Overview

1On November 26, 2025, the applicant requested reconsideration of the Tribunal’s decision released November 5, 2025 (“decision”).

2Stemming from an accident on December 25, 2017, and a request for benefits made pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”), the parties participated in a two-day videoconference hearing. This hearing addressed the substantive issues in dispute.

3In the decision, the Tribunal found it did not have the jurisdiction to consider the applicant’s removal from the Minor Injury Guideline (“MIG”) as a standalone issue. It further concluded that the applicant was not entitled to an income replacement benefit (“IRB”), an award, or interest.

4The grounds for a request for reconsideration are found in Rule 18.2 of the Licence Appeal Tribunal Rules, 2023 (“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; or

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.

5The applicant relies on Rule 18.2(a) and Rule 18.2(b) to support her request. She is also seeking costs from both the respondent and the Tribunal.

6The respondent asks the Tribunal to dismiss the applicant’s request for reconsideration. It did not address the costs request in its submissions.

Result

7The applicant’s request for reconsideration is dismissed.

8The applicant’s costs requests against the respondent and the Tribunal are denied.

Analysis

9The test for reconsideration under Rule 18.2 involves a high threshold, and the requesting party—in this case, the applicant—must show how or why the decision falls into one of the categories in Rule 18.2. 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.

10I note that the applicant did not have a legal representative to assist her with this stage of the proceeding. As such, some of the grounds she raised in support of her request for reconsideration are a bit unclear. However, I have reviewed her submissions in detail, and it appears she is raising seven grounds to challenge the Tribunal’s decision. I will address each of them in turn.

11First, the applicant claims that the respondent needed to “appeal the decision of the Notice of Motion on jurisdictional issue” in line with Rule 18.1 of the Tribunal’s Rules. She appears to be referring to the motion order that the Tribunal released on July 29, 2025. In this motion order, the Tribunal dismissed the respondent’s request for a further case conference. One of the topics that the respondent sought to address through this further case conference was “whether the Tribunal has jurisdiction to determine if the applicant’s injuries fall within the Minor Injury Guideline”.

12The applicant appears to believe that this jurisdictional issue was decided as part of this motion order. The Tribunal did not decide this jurisdictional issue in the motion order, but rather noted that the respondent could (at paragraph 9) “seek a ruling on whether the Tribunal has jurisdiction” over the applicant’s claim for removal from the MIG. There was, therefore, no need for the respondent to reconsider this jurisdictional issue through Rule 18.1. Instead, the Tribunal correctly and fairly considered this issue as a defense against the applicant’s request to be removed from the MIG during the videoconference hearing.

13Second, the applicant claims this reconsideration of the July 29, 2025 motion order was done in accordance with Rule 18.5, a rule that allows the Tribunal to reconsider any decision on its own initiative, so long as the review is done “within a reasonable time after the decision or order is made.” The applicant, therefore, appears to claim that the Tribunal did not reconsider this order within a reasonable amount of time following its release on July 29, 2025.

14She also alludes to how this reconsideration process took place at the videoconference hearing without any opportunity for the parties to make submissions. The applicant believes this procedural choice shows bias on the part of the Tribunal.

15Once again, I note that the respondent’s motion was not reconsidered during the videoconference hearing. Rather, in the motion order, the respondent’s request for a further case conference to address the Tribunal’s jurisdiction was rejected, not the underlying issue of the Tribunal’s jurisdiction itself. This jurisdictional issue correctly proceeded to be addressed at the videoconference hearing.

16Third, the applicant submits that her appeal of the MIG and IRB issues were made within the limitation period set out in s. 56 of the Schedule. There was no discussion of s. 56 in the decision, so I am not clear on how this ground for reconsideration amounts to unfairness or an error on the part of the Tribunal.

17Fourth, the applicant argues that the Tribunal materially breached her right to procedural fairness by finding that her injuries were minor in nature. Specifically, she claims to have sustained a “chronic concussion at the time of the accident which left untreated is persistent post-concussion syndrome, a skull fracture, fatigue, chronic pain, and brain injury”. The applicant points to Tambyah v. Economical Insurance Company, 2022 CanLII 14960 (ON LAT) (“Tambyah”) as an example of a case where an applicant was removed from the MIG due to a concussion. She claims there is ample support for her MIG position in her medical evidence.

18In the decision, the Tribunal dismissed the applicant’s request to be removed from the MIG based on its conclusion that it does not have jurisdiction to deal with the MIG as a standalone issue without some related claim for a medical or rehabilitation benefit. The core of this analysis is found at paragraph 11 of the decision:

While I am not bound by Tribunal decisions, I find the reasoning in Bobak v. Travelers Insurance, 2022 CanLII 146 (ON LAT) and Rogh v. Aviva Insurance Canada, 2023 CanLII 40141 (ON LAT) both persuasive and relevant to the issue at hand. Section 280 of the Insurance Act is clear that applications to the Tribunal may only be made to resolve a dispute in respect of a person’s entitlement to a statutory accident benefit or the amount of a benefit. The MIG is not a statutory accident benefit, but a guideline. The Schedule does not provide for an insured person to apply for a MIG determination on its own without a related underlying dispute.

19In other words, the Tribunal’s dismissal of the applicant’s MIG claim did not involve an assessment of her medical condition. The Tribunal instead found it did not have the jurisdiction to address this issue. Therefore, though the applicant may claim that there is ample medical evidence to support her position, she has not addressed the core question at the heart of the MIG determination, i.e., the Tribunal’s jurisdiction. I also note that Tambyah involved both the MIG and claims for disputed medical benefits.

20Fifth, the applicant appears to raise several arguments about the IRB, namely, it is clear she has not been able to work since the accident and she has a complaint about the parties’ exchange of documents. These arguments are unclear, but, regardless, they appear to be disagreements with the outcome of the decision.

21I do note that the applicant contends that the Tribunal erred in finding that the respondent did not breach its obligations under s. 36. After setting out the legal test and reviewing the parties’ positions on s. 36, the Tribunal explained why it did not endorse the applicant’s argument at paragraph 31 of the decision:

I find that the respondent’s letters to the applicant adequately explained the problem with the disability certificates that the applicant submitted in December 2022. Specifically, while Dr. Papini completed the forms, she was unable to comment on any disability related to the accident as she had only treated the applicant in a dental capacity as of July 18, 2022. While the revised form had certain boxes marked “yes”, Dr. Papini confirmed in her subsequent letter to the respondent that she did not check those boxes. I find that the respondent’s letters explain that, for the above reasons, Dr. Papini’s disability certificate does not confirm the applicant’s eligibility for an IRB. The respondent’s letters to the applicant dated December 8, 2022 and January 6, 2023 explain the medical and any other reasons for the respondent’s belief, as required under s. 36(4) of the Schedule.

22The applicant may disagree with this determination (as well as the Tribunal’s overall findings about the IRB), but disagreement alone is not enough to trigger reconsideration. Without an explanation for why the Tribunal erred in fact or law in reaching these conclusions, or that these determinations amount to a material breach of procedural fairness, I find the applicant has not met her onus on reconsideration.

23Sixth, the applicant claims she is entitled to a lost education expense. There is no indication in either the Case Conference Report and Order (released April 29, 2025) or the decision that this issue was ever considered a part of the parties’ dispute before the Tribunal. There is also no indication in the applicant’s request for reconsideration that she attempted to add this expense as an issue. As such, I see no error or unfairness in the Tribunal’s choice not to address this claim.

24Finally, the applicant disagrees with the Tribunal’s decision to deny her award request. She cites Vivekanantham v. Certas Direct Insurance Company, 2024 ONSC 6198 in support of this argument. This submission again appears to be an improper request to re-litigate the parties’ positions and evidence from the hearing. I also note that, since the Tribunal originally found there are no payments owing to the applicant (and she has not successfully raised any grounds to challenge the decision on reconsideration), there is no basis upon which to grant an award under s. 10 of Reg. 664.

25I am sympathetic to the applicant. She is attempting to navigate this process without the assistance of legal representation. I am also mindful of the medical challenges noted in her reconsideration submissions. However, it is still up to the applicant to show that her request meets the test for reconsideration under Rule 18.2. I find she has not met this onus.

26Overall, I find the applicant has not established any grounds for reconsideration.

Costs Request

27I do not find the applicant has met the high threshold necessary for ordering costs.

28Rule 19.1 states that the Tribunal may award costs when “another party in a proceeding has acted unreasonably, frivolously, vexatiously, or in bad faith”. The party requesting costs has the onus to demonstrate such an order is merited. The applicant is seeking costs from both the respondent and the Tribunal.

29First, I find the applicant has not established that the respondent’s behaviour merits an order for costs. In support of this request, the applicant submits that the respondent “acted unreasonably and in bad faith”. This brief statement is insufficient to meet the high threshold needed to order costs under Rule 19.1.

30Second, Rule 19.1 only permits a party to ask for a costs from another party in the proceeding, not the Tribunal itself.

31Taken together, the applicant’s requests for costs from the respondent and the Tribunal are both denied.

Conclusion & Order

32The applicant’s request for reconsideration is dismissed.

33The applicant’s costs requests against the respondent and the Tribunal are denied.

Craig Mazerolle Vice-Chair