Licence Appeal Tribunal
RECONSIDERATION DECISION
Before:
Craig Mazerolle, Vice-Chair
Licence Appeal Tribunal File Number:
25-000171/AABS
Case Name:
Hamed Almohamad v. Certas Home and Auto Insurance Company
Written Submissions by:
For the Applicant:
Hamed Almohamad, Applicant
For the Respondent:
Andrea R. Lim, Counsel
OVERVIEW
1On February 4, 2026, the applicant requested reconsideration of the Tribunal’s decision released January 27, 2026 (“decision”).
2Stemming from an accident on September 15, 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 videoconference hearing. They had the assistance of an Arabic language interpreter.
3According to paragraph 2 of the decision, “the applicant advised” the Tribunal at the start of the hearing that six treatment plans and the award request had been withdrawn. This change meant the remaining issues in dispute were: catastrophic impairment based on Criteria 7 and 8; an attendant care benefit; a treatment plan for a physiotherapy assessment and services; and interest.
4The Tribunal determined that the applicant was not catastrophically impaired, nor was he entitled to any of the benefits in dispute. His request for interest was also denied.
5The applicant was represented by counsel during this hearing. He no longer has legal representation.
6The 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.
7The applicant relies on all three Rule 18.2 criteria to support his request. He is asking the Tribunal to reconsider the decision; to permit the inclusion and review of certain invoices and medical information; and to provide guidance on how “to address the issues that were withdrawn without my informed consent”.
8The respondent asks the Tribunal to dismiss the request for reconsideration.
RESULT
9The applicant’s request for reconsideration is dismissed.
ANALYSIS
10The 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.
11As a preliminary comment, the applicant does not connect his grounds for reconsideration to the specific criteria under Rule 18.2. However, I am mindful of the fact that he is proceeding with this request without the assistance of counsel or a paralegal. Therefore, despite this procedural glitch, I will review his arguments through the lens of the three different criteria under Rule 18.2.
12The applicant raises five main issues with the decision. I will address them in turn.
Withdrawn Issues
13First, the applicant claims that “several key medical assessments and treatment-based matters were withdrawn at the hearing without my knowledge or informed consent”. Specifically, the applicant alleges that his former counsel removed certain issues without his authorization. He also claims these withdrawals meant certain medical evidence was not presented during the hearing.
14As referenced above, certain issues were withdrawn at the start of the hearing (at paragraph 2 of the decision): “At the start of the hearing the applicant advised the following issues were withdrawn…”. The applicant was represented by counsel during this multi-day event, and there is no indication in the decision that this withdrawal was done under duress.
15Though I recognize that he does not believe he consented to these withdrawals, I find the applicant has not shown how the Tribunal’s decision to accept that these issues had been removed from the dispute was incorrect or procedurally unfair. The respondent provided a transcript of the parties’ conversations with the adjudicator at the start of the hearing. It is clear that the applicant’s former counsel went through a number of the issues listed in the case conference report and order, and she stated that certain issues were no longer being contested by the applicant.
16Lawyers and paralegals are considered “officers of the court”. This means the statements they make to courts and tribunals are presumed to be truthful. This presumption is especially important when they are speaking about the interactions they have had with their own clients. After reviewing the relevant section of the transcript, I find the Tribunal correctly accepted counsel’s clear statements about the removal of these issues. I further find there was no breach of procedural fairness in how the Tribunal conducted itself in this regard. It was entitled to accept the statements from applicant’s former counsel to be true.
17In his reply, the applicant asserts that this “matter should have been addressed directly with the injured person, not solely with the legal representative”. The applicant included a highlighted copy of the transcript showing when the adjudicator stated that the review of the issues would be done without the assistance of the Arabic language interpreter.
18I can infer from this argument and highlighted passage that the applicant believes the decision to have the interpreter stand down meant he was left unaware that these issues were being removed. Once again, the Tribunal was entitled to accept the statements made by his former counsel as truthful, especially as they related to conversations that purportedly took place between a legal representative and the client. I also note that the adjudicator herself supported this decision to have the interpreter stand down by stating: “I’m going to do that without interpretation because I’m sure his counsel has gone through that with him thoroughly.”
19Further, though the applicant claims that certain evidence related to these issues were not presented during the hearing, I find he has not identified what specific evidence he is referring to. In fact, from reviewing the transcript, it appears that some of the withdrawn treatment plans were never incurred, e.g., the optometry assessment. As such, it is unclear whether there would have been any evidence that could have been presented from some of these issues, aside from the OCF-18 form.
20Second, the applicant argues “the Tribunal was not presented with outstanding treatment debts, including unpaid invoices for psychological and physiotherapy services that I received in good faith”. According to the applicant, the fact that he was not deemed catastrophically impaired now means that he is “personally responsible for paying these debts”. He included two invoices with his reply that show he incurred expenses for physiotherapy services and psychological treatment. He claims that this evidence “could have changed the outcome”.
21I do not find the applicant has shown how reviewing these invoices would likely have impacted the outcome of the decision, pursuant to either Rule 18.2(b) or Rule 18.2(c).
22I reach this finding for two reasons. First, none of the issues (including those that were withdrawn) related to psychological treatment. There was a mental health assessment that was removed from the dispute, but there was no disputed plan relating to psychological treatment itself. Additionally, though evidence of incurred psychological treatment post-accident may have supported the existence of ongoing psychological symptomology, I am not satisfied that the consideration of this single invoice would likely have affected the outcome. Rather, the decision involved an extensive review of the parties’ expert and treating psychological evidence, including both the applicant’s pre- and post-accident condition.
23Turning to the physiotherapy invoice, though these services remained in dispute, this plan was found not to be reasonable and necessary based on the medical evidence. As such, there was no need to consider whether these services had been incurred, because the plan was not payable. Additionally, the Tribunal denied payment of this plan following an extensive review of the available medical evidence. I am not satisfied that reviewing this single invoice would likely have impacted the outcome of this analysis.
24Taken together, I do not see how consideration of these invoices would likely have impacted the outcome of the decision, pursuant to either Rule 18.2(b) or Rule 18.2(c).
Impairment Ratings
25Third, the applicant highlights how the Tribunal’s impairment ratings for his claim of catastrophic impairment were “lower than the assessments provided by both my treating professionals and the insurer’s assessors”. As such, he believes that “critical medical information was missing or not fully evaluated”.
26I do not agree. Beyond the fact that the applicant does not point to any specific ratings in his reconsideration submissions, the Divisional Court has stated in Paesano v. Coseco Insurance Co., 2025 ONSC 3245, that the Tribunal may diverge from the assessors’ impairment ratings (at paragraph 61):
The Tribunal did not accept one assessor over the other, it rejected both assessors' evidence, a decision available to the Tribunal. The Tribunal did not give any rating for mental-behavioural WPI because the Applicant did not prove her case. This a reasonable finding based on the evidence before the Tribunal. The application cannot succeed on this ground.
27Put another way, so long as they ground their analysis in the available evidence, it is open to adjudicators to reject both sides’ opinions. From my review of the decision, it is clear that the Tribunal conducted an extensive review of the medical evidence in reaching its conclusions about Criteria 7 and 8. The Tribunal also provided comprehensive reasons that compared the parties’ expert opinions. I see no unfairness or error in this approach.
Surveillance Evidence
28Fourth, the applicant challenges the “disproportionate” reliance the Tribunal placed on the respondent’s surveillance evidence, especially considering how “the reviewing physicians did not change their medical opinions” after they reviewed it. He also disputes the veracity of the surveillance, claiming it differs greatly from the functional limitations observed in other evidence.
29I do not accept this ground for reconsideration. In the decision, the Tribunal conducted an extensive review of this evidence, and it explained what role it played in its analysis. For instance, at paragraphs 126 and 131, the Tribunal contrasted this evidence against the opinion of one of the applicant’s assessors:
The respondent relies on video surveillance taken on 18 different days. It shows the applicant participating in a number of activities that requires concentration, persistence and pace. The applicant was seen driving a car and e-bicycle with his child as a passenger on several occasions sometimes for a period of 20 minutes or more. It is the respondent’s position that to be able to drive especially with his child as a passenger proves the applicant has an ability to concentrate and focus when needed. The applicant was also observed taking a bus and arriving at his destination, placing an order at Tim Hortons, banking, using his cell phone, interacting with a sales agent and taking an SUV for a test drive at a dealership. Further, during the same surveillance period, the applicant was observed exchanging money with a tow truck driver in what appears to be the sale of a vehicle. The applicant confirmed in his testimony that he was in the process of selling his van at that time. On January 14, 2025, the surveillance reflected the applicant running errands and then installing a camera on the outside of his home. The respondent argues all of these activities require a level of persistence, pace and concentration, which the applicant was able to maintain.
The surveillance evidence also does not support Dr. Jwely’s findings. The applicant on numerous occasions demonstrates he has an ability to persist, when need be, for example when he was changing the oil in his car or installing the videocamera [sic] in the front of his house. He is able to concentrate to drive, with his child on the back of an e-bike and engage in a transaction to sell his vehicle and take a new vehicle on a test drive.
30Though the applicant may claim that more attention should have been paid to the other medical evidence on hand, this submission appears to be a request to re-weigh the evidence. As noted above, the reconsideration process is not a venue for asking the Tribunal to re-weigh evidence that was considered at first instance.
31Further, though the applicant may disagree that these videos are an accurate representation of his condition and limitations, adjudicators are empowered to consider different aspects of the overall record when assessing the relative weight that different pieces of evidence will receive. Unless a requesting party can show that a part of this analysis was legally impermissible or factually incorrect, these assessments will not be disrupted on reconsideration.
Respondent’s Conduct
32Finally, the applicant takes issue with what he sees as a “lack of good faith” in the respondent’s handling of his claim. For instance, the applicant claims that the respondent “spent significantly more on assessments, surveillance, and legal expenses than on providing actual treatment and care”.
33Though I recognize that the applicant believes the respondent should have conducted itself in a different manner, the fact remains that, as the insured person, he had the onus to show the Tribunal he was both catastrophically impaired and entitled to the disputed benefits. Put another way, regardless of how an insurer decides to adjust the claim and conduct the hearing, the onus to present evidence and arguments remains with the insured person. The Tribunal assessed the applicant’s claim, and it found he did not meet this onus. Therefore, I do not find the applicant has shown how the respondent’s conduct triggers any of the grounds for reconsideration under Rule 18.2.
34Taken together, I find the applicant has not established any grounds for reconsideration under Rule 18.2.
CONCLUSION & ORDER
35The applicant’s request for reconsideration is dismissed.
Craig Mazerolle
Vice-Chair
Released: May 20, 2026