Licence Appeal Tribunal
RECONSIDERATION DECISION
Before: Craig Mazerolle, Vice-Chair
Licence Appeal Tribunal File Number: 24-003751/AABS
Case Name: Fiona Kelly v. Intact Insurance Company
Written Submissions by:
For the Applicant: Brent McQuestion, Counsel
For the Respondent: Christine Haddad, Counsel
OVERVIEW
1On February 9, 2026, the applicant requested reconsideration of the Tribunal’s decision released January 30, 2026 (“decision”).
2An amended version of the decision was released on February 12, 2026. The sole change made to the decision was a correction to the respondent’s representative’s name.
3Stemming from an accident on September 1, 2018 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 written hearing. In the decision, the Tribunal found that no attendant care benefits (“ACB”) were payable to the applicant up to the date of the decision. No order was issued concerning the possible entitlement to an ACB on an ongoing basis past this date. The Tribunal further denied the claims for six partially approved treatment plans and 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(b) to support her request. The request is limited to the ACB, as she is asking the Tribunal to vary the decision to find she is entitled to an ACB in the amount of $2,058.90 per month on an ongoing basis (provided that she incurs such benefits).
6The respondent asks the Tribunal to reject the applicant’s request to vary the decision. Further, if it is determined that the Tribunal erred by not issuing an order concerning the applicant’s entitlement to an ACB on an ongoing basis, the respondent seeks to either have supplementary reasons issued about the ACB quantum, or to have the matter sent for a rehearing.
RESULT
7The applicant’s request for reconsideration is granted.
8Pursuant to Rule 18.4, the question of ongoing entitlement to the ACB shall be addressed by a new adjudicator based on a review of the submissions and evidence from the written hearing.
ANALYSIS
9The test for reconsideration under Rule 18.2 involves a high threshold, and the requesting party 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.
Rule 18.2(b) – Error of Fact or Law
10In the case conference report and order (released August 21, 2024), the Tribunal defined the ACB issue as follows (emphasis added): “Is the applicant entitled to attendant care benefits in the amount of $2,058.90 per month from May 15, 2024 to date and ongoing?
11At paragraph 2(1) of the decision, the Tribunal used the same language from the case conference report and order to define this issue (emphasis added): “Is the Applicant entitled to attendant care benefits in the amount of $2,058.90 per month from May 15, 2024, to date and ongoing?”
12The ongoing nature of the ACB claim was reiterated at paragraph 15 of the decision (emphasis added): “The Applicant submits that she is entitled to $2,058.90 in ACBs per month from May 15, 2024, to date and ongoing.”
13Despite this consistent characterization, the applicant argues the Tribunal did not issue an order regarding her entitlement to this benefit for any period past the date of the decision. Specifically, as ordered at paragraph 79, the Tribunal relied on its finding that the applicant had not incurred any attendant care services to find that she was not entitled to any ACB payment up to the date of the decision: “I find that the attendant care benefits are not payable to the date of this decision.”
14The applicant claims this silence amounts to an error, as the Tribunal “failed to properly exercise its jurisdiction” by not explicitly determining the issue at hand. I agree. Not only did the Tribunal itself define the issue as a request for ongoing benefits, but, as noted at paragraph 15 of the decision, the applicant argued that she is entitled to an ACB on an ongoing basis. By not issuing any explicit order for this period, I find the applicant has shown there is an error.
15Further, if the Tribunal had issued an order about this period, I find it is likely that the outcome of the decision would have been different. The Tribunal would have turned its mind to the applicant’s entitlement during this later period, and this focus would have likely impacted the outcome of the ACB issue.
16Taken together, I find the applicant has established an error that meets the standard of Rule 18.2(b).
Rule 18.4 – Rehearing
17The respondent agrees that the case conference report and order framed the ACB issue as a request for ongoing benefits, and it agrees that the decision did not address the applicant’s entitlement past the date of the decision. However, there is a dispute over what the appropriate remedy is under Rule 18.4.
18Once again, the applicant is asking the Tribunal to vary the decision to find she is entitled to an ACB on an ongoing basis. To support this request, the applicant highlights paragraph 22 of the decision where the Tribunal agreed with her expert about the reasonable and necessary nature of the proposed attendant care services:
I find the Applicant has met their burden to establish on a balance of probabilities the reasonableness and necessity of ACBs. Ms. Husein’s report demonstrates that the Applicant requires attendant care in the areas of grooming, feeding, mobility, hygiene, basic supervisory care, coordination of attendant care, medication and bathing.
19The respondent contends there is insufficient reasoning contained in the decision to allow for the applicant’s preferred remedy. It argues there is “no reasoned bridge from the documentary evidence to the specific monthly amount that could be inserted on reconsideration”. For instance, the respondent submits that the decision contained no resolution of the parties’ competing Form 1s, nor was there “any articulation of how the ‘reasonable and necessary’ standard yields a specific quantum”. The respondent asks the Tribunal to either issue supplementary reasons for the ACB section of the decision, or to send this matter for a rehearing based on the submissions from the written hearing. Relatedly, it submits that the applicant’s submissions from the written hearing are themselves deficient, so allowing supplementary submissions at this stage would be unfair.
20In reply, the applicant challenges the respondent’s position that the reasons contained in the decision are insufficient. Citing the reasonableness standard from Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65, the applicant claims that—when its reasons are read in conjunction with the evidentiary record—the basis of the Tribunal’s findings about the reasonable and necessary nature of her ACB claim are apparent. She also argues that the respondent has provided no authority to support its position that there must be a detailed breakdown of the evidence and proposed services when assessing an ACB claim.
21In response to the claim that her written hearing submissions are deficient, the applicant contends that there were a number of issues in dispute, and yet the parties were limited to 15 pages for their initial set of submissions.
22After considering the reasons provided in the decision, I find the most appropriate remedy to address the error identified above is to send the question of ongoing ACB entitlement to a rehearing before a new adjudicator. I accept that the Tribunal issued a finding regarding the “reasonableness and necessity of ACBs” at paragraph 22. However, when this passage is read in the context of the entire ACB section of the decision, I am not clear on whether this finding relates to the question of incurred services, or whether the Tribunal did, in fact, find entitlement to an ACB on an ongoing basis. For instance, at paragraph 24, the Tribunal discusses incurred services and entitlement as a related concept: “Further, as the Applicant bears the onus to prove that ACBs have been incurred I find they have not met their onus and have therefore not established entitlement.”
23Therefore, as opposed to varying the decision to extend the timeframe of the Tribunal’s ACB order, I find the fairest way to proceed is to have a new adjudicator answer the question of ongoing entitlement. I further find there is no need for supplementary submissions, as the case conference report and order put the parties on notice that ongoing ACB entitlement was an issue in dispute for the hearing. Additional submissions will also delay the ultimate resolution of this proceeding.
CONCLUSION & ORDER
24The applicant’s request for reconsideration is granted.
25Pursuant to Rule 18.4, the following issue shall be reheard by a new adjudicator based on the parties’ submissions and evidence from the written hearing: “Is the applicant entitled to attendant care benefits in the amount of $2,058.90 per month from January 30, 2026 to date and ongoing?”
26I am not seized.
Craig Mazerolle Vice-Chair
Released: April 29, 2026