RECONSIDERATION DECISION
Before: Tyler Moore, Vice-Chair
Licence Appeal Tribunal File Number: 25-002353/AABS
Case Name: Hannsh Fogel v. Security National Insurance Company
Written Submissions by:
For the Applicant: Alexander L Chekina, Counsel James W Srebrolow, Counsel
For the Respondent: Maria Bihnam, Paralegal
OVERVIEW
1On October 1, 2025, the applicant requested reconsideration of the Tribunal’s preliminary issue decision dated September 18, 2025 (“decision”).
2The applicant was involved in a motor vehicle accident on December 3, 2021. At the time of the accident, she was employed as an intake coordinator and addictions counsellor. She received an income replacement benefit (“IRB”) from December 11, 2021 until she returned to work full-time on January 17, 2022. She advised the respondent through her counsel of same on February 9, 2022.
3On February 14, 2022, the respondent sent correspondence advising that the applicant’s entitlement to IRBs would cease as of January 17, 2022. The applicant was later terminated from her employment on November 10, 2022, but this was not directly communicated to the respondent, and she did not submit a further OCF-2 or OCF-3.
4On February 24, 2025, the applicant filed an application with the Tribunal, but the IRB was not listed as an issue in dispute.
5At a case conference held on July 3, 2025, the parties agreed to add the issue of whether the applicant is entitled to an IRB. A preliminary issue was also identified: “Is the applicant barred from proceeding to a hearing for an income replacement benefit, because the applicant failed to dispute their denial within the 2-year limitation period?”
6In its preliminary issue decision, the Tribunal found that the applicant was barred from proceeding to a hearing for an IRB because she did not dispute the denial within the two-year limitation period prescribed by s. 56 of the Statutory Accident Benefits Schedule – Effective September 1, 2020 (including amendments effective June 1, 2026 (“Schedule”). Briefly, the Tribunal found that the respondent provided a valid denial of the IRB on February 14, 2022, and the applicant did not provide reasonable grounds to extend the limitation period, pursuant to s. 7 of the Licence Appeal Tribunal Act, 1999, S.O. 1999, c. 12, Sched. G (“LAT Act”).
7The 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.
8The applicant seeks reconsideration pursuant to Rule 18.2(a) and 18.2(b). The applicant seeks an order overturning the Tribunal’s decision and a finding that she is not barred from proceeding with her application.
9The respondent submits that the request for reconsideration should be dismissed.
RESULT
10The applicant’s request for reconsideration is dismissed.
ANALYSIS
11The 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.
Did the Tribunal act outside its jurisdiction or commit a material breach of procedural fairness?
12I find that the applicant has not established grounds for reconsideration under Rule 18.2(a).
13The applicant submits that the Tribunal committed the following material breaches of procedural fairness:
a. At paragraph [6] of the decision, the Tribunal indicated that the applicant was “terminated from her employment on November 10, 2022” and that “this information was not directly communicated to the respondent.” The Tribunal’s statement does not properly consider the fact that there was no effort on the part of the respondent to advise the applicant of her need to disclose same. At paragraph [20] of the decision, the Tribunal even states that “an insurer has a continued obligation to assess an insured’s claim”;
b. The reasoning set out at paragraph [20] is inconsistent with the Tribunal’s finding that she did not directly communicate her ongoing work-related status to the respondent. Specifically, the Tribunal found that the respondent had a continued obligation to assess her claim demonstrate due diligence;
c. According to s. 11 of the Schedule, the respondent should reasonably anticipate and allow for running limitation periods for IRB entitlement, such that the applicant may from time to time “try” to return to work then later be off such that it is up to the respondent to be “diligent” on an ongoing basis; and
d. At paragraphs [25], [29], and [31] of the decision the Tribunal improperly considers the merit of IRB entitlement as part of the preliminary issue hearing.
14I find that at paragraph [18] of the decision, the Tribunal provides a detailed outline of the contents of the respondent’s February 14, 2022 denial. At paragraph [19] of the decision, the Tribunal identified that the denial clearly indicates that the IRB would cease as of January 17, 2022, because the applicant returned to work. The applicant’s disagreement with the Tribunal’s finding does not constitute a material breach of procedural fairness.
15I also find that the Tribunal correctly applied the factors set out in Manuel v. Registrar, 2012 ONSC 1492 in deciding whether to extend the limitation period at paragraphs [25] to [33] of the decision. I am not persuaded that the Tribunal’s brief consideration of the IRB merits constitutes a breach of procedural fairness in a preliminary issue hearing, but rather this analysis is the fourth factor from the test in Manuel.
16I find that paragraph [20] of the decision must be read in its entirety for context. The Tribunal analyzed the respondent’s log note of April 30, 2024, and set out that, according to this log note “no further documents received to indicate the client needs ongoing IRB and if any new information comes that indicated the client is not working then we will require update OCF-3 and address the benefit and will require paystubs.” The Tribunal also noted that “the insurer has a continued obligation to assess an insured’s claim”, and it found that “the evidence noted here demonstrates the respondent’s continued due diligence to assess the file.”
17Paragraph [20] of the decision clearly demonstrates that the Tribunal accepted the log note as evidence of the respondent’s ongoing due diligence in assessing the file, and not that it was evidence that the respondent should have or was required to make greater efforts to advise the applicant of her need to disclose additional documents and information about her work status. I am also mindful that the applicant did not disclose the fact that she stopped working in November 2022 to the respondent until the July 3, 2025 case conference, despite the fact that she did not receive any IRB after January 17, 2022.
18Though the applicant makes reference to Baker v. Canada (Minister of Citizenship and Immigration, 1999 CanLII 699 (SCC) to support her argument that the principles underlying the duty of fairness were not applied, I find that the Tribunal did apply the rules as written, that the applicant was heard, and that the Tribunal justified its findings with substantive reasons.
19Based on the evidence before me, I find that the applicant has not shown that the Tribunal committed a material breach of procedural fairness.
Did the Tribunal make an error of law or fact such that the Tribunal would likely have reached a different result had the error not been made?
20I find that the applicant has not established grounds for reconsideration under Rule 18.2(b).
21The applicant submits that the Tribunal made the following errors of law or fact:
a. The denial letter dated February 14, 2022, references the applicant’s return to work as the basis for the stoppage of IRBs, so at that point there was no dispute. As a result, the applicant’s right to dispute was premature, so the limitation period was not triggered;
b. The respondent requested Notices of Assessment for 2023 and 2024 on June 13, 2025, which demonstrates that the respondent was not diligent in its efforts to continuously assess her claim and s. 44 assessors did not receive certain documents;
c. At paragraph [6] of the decision the Tribunal indicated that the applicant’s job was “terminated”, but at paragraph [13], the Tribunal indicated that the applicant made a “voluntary choice” regarding work cessation;
d. The respondent’s log note from April 30, 2024 is evidence of a request pursuant to s. 33(1) of the Schedule whereby requesting her 2023 and 2024 Notices of Assessment could only be for the determination of IRB entitlement. As a result, it cannot be concluded that her entitlement to IRBs had been settled as of April 30, 2024, and the 2-year limitation period would not have begun until at least April 30, 2024; and
e. Section 11 of the Schedule allows for running limitation periods for IRB entitlement, such that it can be reasonably anticipated by the respondent that the applicant may from time to time “try” to return to work such that it is up to the respondent to be “diligent” on an ongoing basis. If an applicant does not update a respondent, the remedy consistent with s. 33(6) of the Schedule would be limited to denying entitlement for any period before the requested information is provided.
22The respondent submits that the February 14, 2022 denial was valid, advising the applicant that her IRB entitlement would “cease”, and thereby triggering the two-year limitation period pursuant to s. 56 of the Schedule, which expired on February 14, 2024.
23I find that at paragraphs [27] and [32] of the decision, the Tribunal properly considered the denial and the applicant’s explanation for the delay in deciding not to extend the limitation period.
24Turning to the argument that the February 14, 2022 letter did not trigger a dispute about the IRB, I agree with the respondent that the dispute arises from its action to refuse or cease an IRB, and that the applicant’s right to dispute was not premature. Pursuant to the test from Smith v. Co-operators General Insurance Co, 2002 SCC 30 (“Smith”), that is set out at paragraph [10] of the decision, an insurer must provide information about the right to dispute with a proper denial.
25At paragraphs [10], [21] and [22] of the decision, I find that the Tribunal correctly sets out and applies the requirements from Smith, affirming that the limitation period runs from the date of a clear denial. I find that this does not constitute an error of law or fact.
26I accept that the respondent’s subsequent investigative request for Notices of Assessment reflects its ongoing duty to adjust a claim. I find that it does not, however, restart the statutory limitation period pursuant to s. 56.
27I also find that whether the applicant’s job ended voluntarily or by termination is not relevant to the statutory limitation expiration date of February 14, 2024. This non-material error would not likely have changed the Tribunal’s decision result.
28With respect to the applicant’s s.11 and s. 33(6) argument, I find that this turns on whether the respondent’s February 14, 2022 letter was a proper denial. I agree with the applicant that if the denial was not found to be proper, s. 11 and s. 33(6) would apply. However, I have found that the Tribunal properly addressed the denial and the respondent’s subsequent requests for information at paragraphs [20], [27] and [32] of the decision. The Tribunal correctly found that the proper denial triggered s. 56 of the Schedule and the two-year limitation period to appeal. The Tribunal thoroughly considered s. 7 LAT Act at paragraphs [23] to [32] of the decision as a result, and the applicant has not persuaded me that this constitutes an error of law or fact.
29Overall, I find that the Tribunal did not make an error of law or fact such that it would likely have reached a different result had the error not been made.
CONCLUSION & ORDER
30The applicant’s request for reconsideration is dismissed.
Tyler Moore Vice-Chair
Released: January 19, 2026