Licence Appeal Tribunal
RECONSIDERATION DECISION
Before: Craig Mazerolle, Vice-Chair
Licence Appeal Tribunal File Number: 24-001964/AABS
Case Name: Yanique Crooks v. TD General Insurance Company
Written Submissions by:
For the Applicant: Bianca Crocetti, Paralegal
For the Respondent: Ashley Dunkley, Counsel
OVERVIEW
1On February 3, 2026, the respondent requested reconsideration of the Tribunal’s decision released on January 14, 2026 (“decision”).
2Stemming from an accident on December 5, 2021 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 the applicant was removed from the Minor Injury Guideline (“MIG”) on account of an accident-related concussion. The Tribunal also granted the applicant’s requests for five treatment plans, interest, and an award.
3The 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.
4The respondent relies on Rule 18.2(a) and Rule 18.2(b) to support its request. It is seeking an order to set aside the decision and have it re-heard by a Vice-Chair.
5The applicant asks the Tribunal to dismiss the request for reconsideration.
RESULT
6The respondent’s request for reconsideration is granted.
7Pursuant to Rule 18.4, the decision is cancelled. The matter shall be reheard by a different adjudicator based on the parties’ submissions and evidence from the written hearing.
ANALYSIS
8The 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.
PAGE LIMIT
9The respondent’s initial reconsideration submissions are 12 pages in length.
10In the reconsideration order (dated February 4, 2026), the Tribunal noted that the respondent’s initial reconsideration submissions exceeded the 10-page limit set by Rule 18.1. According to the order, it is “at the discretion of the adjudicator hearing the request for reconsideration whether to consider submissions that exceed the prescribed page limit.”
11The applicant asks the Tribunal to disregard any part of the respondent’s initial reconsideration submissions that go beyond the 10-page limit set in Rule 18.1.
12As my reasons below demonstrate, I focused on the respondent’s argument about the sufficiency of the Tribunal’s reasons. Considering this argument was contained within the first half of the respondent’s initial submissions, I do not find the page limit breach had any impact on my assessment of its request.
Rule 18.2(a) – Sufficiency of Reasons
13The respondent raises several issues with the decision. However, I am focusing my analysis on its concerns about the sufficiency of the Tribunal’s reasons.
14As noted by the Supreme Court of Canada at paragraph 79 in Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65 (“Vavilov”), reasons ensure the fairness and legitimacy of administrative decision-making (citations removed):
Reasons explain how and why a decision was made. They help to show affected parties that their arguments have been considered and demonstrate that the decision was made in a fair and lawful manner. Reasons shield against arbitrariness as well as the perception of arbitrariness in the exercise of public power.
15Further, as the Supreme Court stated at paragraph 39 in Baker v. Canada (Minister of Citizenship and Immigration), 1999 CanLII 699 (SCC) (“Baker”), reasons allow decisions to be questioned: “Reasons are invaluable if a decision is to be appealed, questioned, or considered on judicial review”.
16With these principles in mind, I do not find the Tribunal’s reasons meet the standard for sufficiency of reasons as set out by the Supreme Court.
Applicability of the Minor Injury Guideline
17To start, the respondent submits that there is no consideration of its MIG position in the decision. By ignoring its submissions and evidence, the respondent claims it “was denied a fair opportunity to have its position meaningfully addressed”. I agree.
18A fundamental aspect of procedural fairness is the ability of the parties (especially the losing party) to see that its submissions and evidence formed part of the decision-making process. The primary way this consideration is shown to the parties is through the Tribunal’s reasons, such that a failure to include any reference to a party’s case will reasonably lead one to believe that it was not considered.
19The Tribunal’s MIG analysis is contained at paragraphs 7 – 11 of the decision. There is no mention of the respondent’s position or evidence in this section:
The applicant has demonstrated that she is to be removed from the MIG due to a concussion. A Physician’s Statement prepared by Dr. Ali Kassim of Richvale Medical Centre dated December 21, 2021 states that [the applicant] suffers from lower back pain, shoulder pain and strain, neck pain and a concussion due to the accident (Page 737 of Applicants [sic] Submissions).
Section 18(1) of the Schedule provides that medical and rehabilitation benefits are limited to $3,500.00 if the insured person sustains impairments that are predominantly a minor injury. Section 3(1) defines a “minor injury” as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury.”
An insured person may be removed from the MIG if they can establish that their accident-related injuries fall outside of the MIG or, under s. 18(2), that they have a documented pre-existing injury or condition combined with compelling medical evidence stating that the condition precludes recovery from any accident-related minor injury if they are kept within the confines of the MIG. The Tribunal has also determined that concussions, chronic pain with functional impairment or a psychological condition may warrant removal from the MIG. In all cases, the burden of proof lies with the applicant.
The applicant pointed to the concussion diagnosis in their written submissions, pointing to the Attending Physician’s Statement – Short Term Disability Claim/Early Referral Services form dated December 21, 2021. Furthermore, the applicant demonstrates that she reported the following symptoms following the accident:
[List of medical records from Dr. Kassim, Physiocare and Wellness Clinic, and the Credit Valley Hospital.]
I find that the applicant has demonstrated clearly that she should not be held within the MIG based on the diagnosis of a concussion because a concussion and ongoing headaches do not fall within the s.3 definition of a minor injury.
20The absence of the respondent’s submissions is especially significant to this case, as it took the position that her headaches were not accident-related. As quoted above, the applicant’s “ongoing headaches” were one of the key symptoms relied upon by the Tribunal in its MIG analysis.
21The applicant argues that the respondent’s request effectively amounts to a “disagreement with the outcome of the decision”. Specifically, she argues that the Tribunal considered the medical evidence on hand, and it provided sufficient reasons to support its conclusions. I do not agree.
22The respondent’s arguments about the MIG were not trivial, tertiary submissions that did not need to be formally explored in the decision. They formed a key part of its defense against one of the central issues in dispute. This request is, therefore, not a case of a party disagreeing with the outcome. Rather, it is seeking to have its key arguments reflected in the Tribunal’s decision-making process.
Two Treatment Plans for Assessments
23Second, the respondent takes issue with certain wording in the Tribunal’s analysis of the two treatment plans for assessments. It highlights what it believes to be templated language at paragraphs 23 and 24 (emphasis added):
The goal of the psychological assessment is to determine if there is a diagnosis of a psychological impairment, and if so, the plan for treatment. I find that based on the ongoing reported complaints as described in paragraph 10 above, that the treatment plan is necessary because….?. I find that the assessment is also reasonable as it is based on the rates presented by the Schedule.
The goal of the chronic pain assessment is to determine if there is a diagnosis of chronic pain, and if so, the plan for treatment. I find based on the ongoing reported complaints of pain over a period of time that is longer than 6 months, that this treatment plan is necessary because….. I find that the assessment is also reasonable as it is based on the rates presented by the Schedule.
24When assessing the sufficiency of one’s reasons, decision-makers are not held to the standard of perfection. Despite the best efforts on the part of an adjudicator, typos and stray words may still end up in the final product. These minor oversights are anticipated by both the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 and the Tribunal’s Rules, as there are ways to correct the kind of minor hiccups that occasionally arise in the drafting process.
25Yet, I find the two highlighted sections above show the Tribunal went beyond this anticipated sphere of typos and minor corrections. It rather appears the adjudicator left placeholders in the final decision that were meant to remind him to add reasons to support this part of his order. In the words of Vavilov, these placeholders do not guard against “the perception of arbitrariness in the exercise of public power”. Instead, they suggest that the Tribunal found it could order payment of these plans without needing to fully justify its conclusions.
26The applicant again argues that the Tribunal considered and weighed the evidence and arguments presented by the parties, such that the respondent’s reconsideration request should be disregarded as an attempt to re-litigate its case. I again do not find that the respondent is simply disagreeing with the outcome. By highlighting these two leftover placeholders, it has demonstrated that the Tribunal’s reasons did not reach the level of sufficiency required by the Supreme Court.
27In sum, by showing that the Tribunal’s reasons did not meet the standard for sufficiency as laid out in Vavilov and Baker for both the MIG and these two treatment plans, I find the respondent has established grounds for reconsideration, pursuant to Rule 18.2(a).
Rule 18.4 – Cancelling the Decision
28Since the respondent has shown that the Tribunal did not adequately account for its case (and that the Tribunal did not sufficiently explain its conclusions for part of the resulting decision), I find the most appropriate way to proceed under Rule 18.4 is to cancel the decision and have the matter reheard by a new adjudicator. This review will be based on the parties’ evidence and submissions from the written hearing, as I see no need for fresh evidence or arguments from the parties. This arrangement will also allow the dispute to be resolved in a timelier fashion.
29The respondent asked for any rehearing to be conducted by a Vice-Chair, and not a Member. It is solely within the prerogative of the Tribunal to decide what adjudicator shall be assigned to any given case.
CONCLUSION & ORDER
30The respondent’s request for reconsideration is granted.
31Pursuant to Rule 18.4, the decision is cancelled. The matter shall be reheard by a different adjudicator based on the parties’ submissions and evidence from the written hearing.
32I am not seized.
Craig Mazerolle Vice-Chair
Released: May 11, 2026