RECONSIDERATION DECISION
Before: Ulana Pahuta, Adjudicator
Licence Appeal Tribunal File Number: 23-015438/AABS
Case Name: Stacy Dimitropoulos v. Unifund Assurance Company
Written Submissions by:
For the Applicant: Lisa Bishop, Counsel Imtiaz Hosein, Counsel Christos Kakaletris, Counsel
For the Respondent: Ken Yip, Counsel
OVERVIEW
1In a decision dated September 11, 2025, the Tribunal found that the applicant was entitled to interest in accordance with s. 51(4) of the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”) on the balance of a treatment plan dated October 31, 2023. The treatment plan itself was not in dispute, as the respondent had paid the denied balance prior to the hearing. The adjudicator also found that the applicant was entitled to an award under s. 10 of O. Reg. 664 RRO 1990, in the amount of 15% of the amount of the disputed treatment plan.
2On January 9, 2026, the applicant filed a motion with the Tribunal requesting that it clarify its decision by quantifying the amount of the special award interest. On January 15, 2026, the Tribunal informed the applicant that the form of relief she was seeking could only be requested by way of reconsideration.
3On January 26, 2026, the applicant requested a reconsideration of the decision, seeking to clarify the amount of interest the respondent is required to pay the applicant for the 15% lump sum award.
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 did not specify on which ground she sought reconsideration of the Tribunal’s decision. She submits that the ambiguity in the decision relating to interest necessitates a clarification, not a reconsideration. Regardless, the applicant requests that the Tribunal find that the applicant is entitled to interest in accordance with Reg. 664 in the amount of $994.98. From this, I infer that the applicant is requesting that the decision be varied, to include entitlement to interest on the s. 10 award in the amount of $994.98.
6The respondent similarly did not provide submissions on the reconsideration grounds in Rule 18.2. Rather, the respondent’s submissions were limited to whether it was liable to pay any special award interest.
RESULT
7The applicant’s request for reconsideration is granted, in part.
8Pursuant to Rule 18.4, the decision is varied to include entitlement to interest on the s. 10 award, in accordance with Reg. 664.
ANALYSIS
9The 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.
Rule 18.2 – Grounds for Reconsideration
10I find that the applicant has established grounds for reconsideration pursuant to Rule 18.2(b).
11In her request for reconsideration and supporting submissions, the applicant did not specify which Rule 18.2 ground she was relying upon to seek reconsideration of the Tribunal’s decision. However, upon review of the applicant’s reconsideration submissions, it is clear that she is arguing that the Tribunal made an error in law in failing to address the issue of interest in relation to the s. 10 lump sum award. The applicant argues on reconsideration that, while the adjudicator had awarded her a 15% lump sum payment of the disputed treatment plan pursuant to s. 10 of Reg. 664, the adjudicator did not address the “mandatory special award interest rate” of 2% per month, compounded monthly, from the time the benefits first become payable.
12I find that the applicant has established that the Tribunal erred in law in not awarding interest in accordance with s. 10 of Reg. 664.
13Section 10 of Reg. 664 states as follows:
If the Licence Appeal Tribunal finds that an insurer has unreasonably withheld or delayed payments, the Licence Appeal Tribunal, in addition to awarding the benefits and interest to which an insured person is entitled under the Statutory Accident Benefits Schedule, may award a lump sum of up to 50% of the amount to which the person was entitled at the time of the award together with interest on all amounts then owing to the insured (including unpaid interest) at the rate of 2% per month, compounded monthly from the time the benefits first became payable under the Schedule.
14At paragraph 31 of the decision, the Tribunal awarded interest in accordance with s. 51 of the Schedule on the unapproved portion of a treatment plan. The Tribunal also awarded a 15% lump sum award of the same treatment plan, pursuant to s. 10 of Reg. 664. However, the decision was silent on whether interest was payable on the lump sum award pursuant to s. 10 of Reg. 664.
Parties’ Positions
15The applicant submits that s. 10 of Reg. 664 authorizes two components: (i) a lump sum component of up to 50% of the benefits and interest owing; and (ii) a mandatory special award interest component at the rate of 2% compounded monthly, on all amounts then owing (i.e., benefits + interest + lump sum award). She cites the Divisional Court decision Waldock v. State Farm, 2019 ONSC 6105, and a number of Tribunal decisions which together affirm the dual components of a s. 10 award.
16The applicant argues that the special award interest is mandatory, and is not discretionary, if a lump sum award is granted pursuant to s. 10. The applicant submits that once the Tribunal granted the discretionary lump sum percentage award, it follows that interest at 2% compounded monthly must have also been awarded. She argues that failing to apply the mandatory interest component of s. 10 would nullify the deterrent effect of the special award that the Tribunal had granted.
17The respondent’s position is that no clarification of the decision is required, as no additional interest is owing to the applicant under s. 10 of Reg. 664. It submits that the special award percentage should be interpreted as a lump sum with no further calculations needed, since any special award interest calculation is only for the determination of the maximum amount awardable by the adjudicator. It cites the Divisional Court decision Personal Insurance Company v. Hoang, 2014 ONSC 81, in support of its position that any special award interest is included in the discretionary lump sum component under s. 10.
18In the alternative, the respondent argues that no additional interest is payable under s. 10, since the applicant has not submitted invoices to demonstrate that the treatment plan at issue had been incurred. It submits that s. 10 interest is calculated from the time the benefits first become payable under the Schedule. It cites s. 38(15) of the Schedule to argue that a benefit is only payable after it was incurred. Since the applicant has not demonstrated that the benefit has been incurred, the respondent argues that it has not become payable and accordingly, any interest would be $0.
Analysis
19I agree with the applicant that s.10 award interest is mandatory, and is not discretionary. The failure to specify that interest was payable in accordance with s. 10 of Reg. 664, was an error of law.
20Although the respondent cites the Divisional Court decision Hoang to argue that interest pursuant to s. 10 is already included in any lump sum calculation, I agree with the applicant that the more recent Divisional Court decision Waldock is clear that s. 10 award interest is distinct and is in addition to the discretionary lump sum component of a s. 10 award. This is also clear from a plain reading of s. 10 of Reg. 664.
21When considering the modern principle of statutory interpretation set out in Rizzo & Rizzo Shoes Ltd. (Re), 1998 CanLII 837 (SCC), decision makers are to review the words of a provision within their entire context and scheme, with an eye to the object of the legislation. Section 10 states that the Tribunal may award a lump sum of up to 50% of the amount to which the person was entitled “at the time of the award together with interest on all amounts then owing to the insured”. This suggests that the lump sum award amount would be considered as one of the “amounts” to which interest under s. 10 will accrue. In my view, the use of the plural term “amounts” points to an inclusive approach to interest accrual. Accordingly, I do not agree with the respondent that special award interest is included in the discretionary lump sum component under s. 10.
22I also agree with the Tribunal decision J.T. v. Certas Home and Auto Insurance Company, 2023 CanLII 52472 (ON LAT), cited by the applicant, that the 2% compounded interest referred to in Reg. 664 is mandatory and is not within the adjudicator’s discretion. I agree with the reasoning in J.T. that the Schedule is consumer protection legislation, and that interest is a consequence of an insurer’s delay in the payment of, or unreasonable withholding of, accident benefits. Further, that when reading s. 10 in its grammatical sense, it does not support the position that the 2% compounded interest is discretionary.
23I further am not persuaded by the respondent’s alternative argument, that no additional interest is payable under Reg. 664, since the applicant has not demonstrated that the treatment plan at issue has been incurred. It argues that s. 10 interest is calculated from the time the benefits first become payable under the Schedule and that under s. 38(15) a benefit is only payable after it was incurred. I agree with the applicant that the Tribunal has already decided at paragraphs 22 to 28 of the decision that the applicant was entitled to an award as a result of the respondent’s delay in approving the treatment plan. The entitlement to an award was not dependent on whether the treatment plan had been incurred.
24Accordingly, I find that the failure to specify that interest was payable in accordance with s. 10 of Reg. 664 on the lump sum award, was an error of law. Given that the inclusion of special award interest would have changed the quantum of the special award claim, I find that this was an error such that the Tribunal would likely have reached a different result had the error not been made.
Rule 18.4 – Varying the decision
25Since the applicant has established grounds for reconsideration in relation to the granting of interest in accordance with s. 10 of Reg. 664, I must now determine what the appropriate remedy is under Rule 18.4.
26The applicant requests that a clarifying order be issued, specifying the amount of special award interest under s. 10 that the respondent is liable to pay. The applicant submits that on September 25, 2025, after the release of the decision, the respondent issued payment to the applicant for the s. 51 interest on the unapproved portion of the treatment plan and the 15% lump sum award (although the respondent agrees that it mistakenly only paid $99.58 in s. 51 interest, rather than the correct amount of $110.25). However, the respondent did not pay the special award interest component of the decision. She relies on an accounting report prepared by JS Held dated December 5, 2025, which quantified the s. 10 interest to be $994.98, using a payment reference date of January 1, 2026.
27I find that the appropriate remedy is to vary the decision to confirm that the applicant is entitled to interest payable in accordance with Reg. 664. Accordingly, the decision is varied at paragraphs 5 and 30(ii) of the decision. These paragraphs shall now read:
The respondent is required to pay an award of 15% of the disputed treatment plan, plus interest in accordance with Reg. 664.
28The applicant’s request to identify the amount of special award interest payable by the respondent to be $994.98, is denied. Reconsideration is a limited, error correcting exercise. I agree with the applicant that the lack of clarity as to whether interest was payable in accordance with Reg. 664 was an error in law. This error has been rectified as part of this reconsideration decision.
29However, the reconsideration process is not an appeal or a new hearing of the issues in dispute. The applicant has provided an accounting report which quantifies the outstanding amount using a payment reference date of January 1, 2026. However, it is unclear why this date was chosen, or whether the respondent has agreed with this reference date. Therefore, I find that I do not have sufficient information to confirm the amount of interest under Reg. 664, as requested by the applicant.
CONCLUSION & ORDER
30The applicant’s request for reconsideration is granted, in part.
31Pursuant to Rule 18.4 the decision is varied at paragraphs 5 and 30(ii). These paragraphs shall now read:
The respondent is required to pay an award of 15% of the disputed treatment plan, plus interest in accordance with Reg. 664.
Ulana Pahuta Adjudicator
Released: May 28, 2026