Citation: Morina v. Echelon General Insurance Company, 2026 ONLAT 25-010658/AABS - PI

Licence Appeal Tribunal File Number: 25-010658/AABS

In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.

Between:

Katrina Morina

Applicant

and

Echelon General Insurance Company

Respondent

PRELIMINARY ISSUE HEARING DECISION AND ORDER

ADJUDICATOR:

Nadia Mauro

APPEARANCES:

For the Applicant:

Jade Borne, Paralegal

For the Respondent:

Jamie Pollack, Counsel

Nicholas Wine, Counsel

HEARD: By way of written submissions

OVERVIEW

1Karina Morina, the applicant, sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (the “Schedule”) as a result of her mother being involved in a motor vehicle accident on December 2, 2012. The applicant was denied benefits by the respondent, Echelon General Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

PRELIMINARY ISSUES IN DISPUTE

2The preliminary issue to be decided is:

1. Is the applicant barred from proceeding with their claim for benefits as they failed to submit the application for benefits (OCF-1) within the time prescribed in the Schedule?

RESULT

3The applicant is barred from proceeding with her application.

PROCEDURAL ISSUE

The applicant’s submissions exceed the page limit

4In its reply submission, the respondent submits that the applicant’s submissions do not comply with the Case Conference Report and Order, dated January 22, 2026, wherein the parties’ submissions were to be no longer than 6 pages in length, double spaced.

5The applicant’s submissions are 6.5 pages in length with 1.5 spacing. I fail to see how the respondent has been prejudiced by the applicant’s submission length and spacing given that it has been able to make a fulsome response. In any event, despite raising issue with the applicant’s submissions, the respondent does not ask for any specific relief. Therefore, I will consider the applicant’s original submissions, in their entirety.

ANALYSIS

Background

6On December 2, 2012, the applicant’s mother, Neely Morina, was involved in a motor vehicle accident. The applicant was seven years old at the time of the accident and was not a passenger in the vehicle.

7On June 14, 2023, Neely Morina passed away.

8On November 14, 2024, the applicant sought legal advice and an OCF-1 was submitted to the respondent. The applicant was 19 years old at the time she submitted the OCF-1.

9On February 10, 2025, the applicant underwent an Examination Under Oath (EUO) with the respondent.

10On March 6, 2025, the respondent denied the applicant’s claim for accident benefits for failing to comply with the timeline set out in s. 32(1) and failing to provide a reasonable explanation for the delay.

The Law

11Section 32(1) of the Schedule provides that a person who intends to apply for accident benefits shall notify the insurer of their intention no later than the seventh day after the circumstances arose that give rise to the entitlement to the benefit, or as soon as practicable after that day.

12Once an insurer receives notice of an applicant’s intention to apply for statutory accident benefits, s. 32(2) requires the insurer to provide the applicant with the appropriate OCF-1 forms, a written explanation of benefits available, information to assist the person in applying for benefits and information on the election relating to income replacement benefits, non-earner benefits and caregiver benefits, if applicable. Pursuant to s. 32(5) of the Schedule, the applicant must then submit a completed and signed application for benefits to the insurer within 30 days after receiving the application forms.

13Section 34 of the Schedule states that “a person’s failure to comply with a time limit set out in this Part does not disentitle the person to a benefit if the person has a reasonable explanation.” The onus is on the applicant to establish a reasonable explanation for the delay.

14The interpretation of “reasonable explanation” is guided by Horvath v. Allstate Company of Canada, 2003 ONFSCDRS 92 (“Horvath”) and was more recently reiterated in K.H. v. Northbridge General Insurance Company, 2019 CanLII 101613 (ON LAT) (“K.H.”). The guiding principles are summarized as follows:

1. An explanation must be determined to be credible or worthy of belief before its reasonableness can be assessed.

2. The onus is on the insured person to establish a “reasonable explanation”.

3. Ignorance of the law alone is not a “reasonable explanation”.

4. The test for “reasonable explanation” is both a subjective and objective test that should take account of both personal characteristics and a “reasonable person” standard.

5. The lack of prejudice to the insurer does not make an explanation automatically reasonable.

6. An assessment of reasonableness includes a balancing of prejudice to the insurer, hardship to the claimant, and whether it is equitable to relieve against the consequences of the failure to comply with the time limit.

15Additionally, pursuant to Hussein v. Intact Insurance Company, 2025 ONSC 842 (“Hussein”), an interpretation of s. 32(1) must recognize the reality that consumers who have motor vehicle accidents are in a vulnerable position, particularly in the period immediately following the accident. Hussein provides that the insurer has a positive obligation to inquire and assist an insured person with their application for accident benefits and affirms that insurers cannot simply rely on the insured person’s inaction to determine that no benefits will be claimed.

Parties’ Positions

16The respondent submits that the applicant completed an OCF-1 on November 14, 2024, almost 12 years after her mother’s accident and almost two years after turning 18 years of age. The respondent relies on the Tribunal decision in Keene v. Aviva General Insurance, 2023 CanLII 98422 (ON LAT) (“Keene”) wherein the applicant was a minor involved in an accident and submitted an OCF-1 roughly four years after the accident, and approximately 1.5 years after turning 18. In Keene the Tribunal rejected the applicant’s “reasonable explanation”, in part, because it held that the Tribunal’s jurisdiction and discretion under s. 7 of the Licence Appeal Tribunal Act, 1990, SO 1999, c 12, Sch G (“LAT Act”) applies to the extension of time to file an application with the Tribunal pursuant to s. 56 of the Schedule, not to notice pursuant to s. 32(1) of the Schedule.

17The respondent’s position is that the mere fact that an applicant is a minor at the time of the accident does not in of itself constitute a reasonable explanation for the delayed OCF-1.

18The applicant submits that she was 7 years old at the time of her mother’s accident, and because of this, she argues that she had until age 20 to claim benefits. It is the applicant’s position that while s. 32(1) of the Schedule states a person who intends to apply for accident benefits shall notify the insurer within 7 days, this does not apply to a minor who suffers a psychological impairment and who was not involved in the accident. The applicant submits she was 19 at the time she submitted her claim for accident benefits, and as such, her limitation to apply for benefits had not expired. It is the applicant’s position that the respondent had no basis for requiring a reasonable explanation because the applicant was within the timeline to apply for benefits. The applicant further submits that she was estranged from her mother for many years prior to her mother’s passing in 2024. The applicant submits that she had no legal representation before she reached the age of majority, and until 2024.

19The applicant further submits that contrary to the respondent’s reliance on Keene, s. 7 of the LAT Act does not relate only to extending a Tribunal application timeline. The applicant argues this is incorrect and would not supersede the Court of Appeal’s decision in Tomec v. Economical Mutual Insurance Company, 2019 ONCA 882, wherein the court states at para 16:

“The SABS are remedial and constitute consumer protection legislation. As such, it is to be read in its entire context and in their ordinary sense harmoniously with the scheme of the Act, the object of the Act, and the intention of the legislature. The goal of the legislation is to reduce the economic dislocation and hardship of motor vehicle accident victims and, as such, assumes an importance which is both pressing and substantial.”

20The applicant also relies on the Tribunal decision in Smai v. The Personal Insurance Company, 2025 CanLII 102223 (ON LAT) (“Smai”), wherein the Tribunal held that minors occupy a legally distinct position within the accident benefits regime and that procedural timelines must be interpreted in a manner consistent with the Schedule’s consumer protection purpose.

21The Court of Appeal decision in Tomec makes it clear that when faced with a choice between an interpretation that furthers the public policy objectives underlying the Schedule and one that undermines them, the only reasonable decision is to adopt the former.

22In Smai, it was held that the term “court” under s. 2 of the Limitations Act, 2002, S.O. 2002, c. 24, Sched. B (“Limitations Act”) was interpreted to include the Tribunal, and therefore, claims related to a minor involved in an accident were subject to s. 6 of the Limitations Act.

23Section 2 of the Limitations Act states:

“2 (1) This Act applies to claims pursued in court proceedings other than,

(a) proceedings to which the Real Property Limitations Act applies;

(b) proceedings in the nature of an appeal, if the time for commencing them is governed by an Act or rule of court;

(c) proceedings under the Judicial Review Procedure Act;

(d) proceedings to which the Provincial Offences Act applies;

(e) proceedings based on the existing aboriginal and treaty rights of the aboriginal peoples of Canada which are recognized and affirmed in section 35 of the Constitution Act, 1982;

(f) proceedings based on equitable claims by aboriginal peoples against the Crown; and

(g) proceedings to which the Limitation Convention or the Amended Limitation Convention, as defined in the International Sales Conventions Act, applies. 2002, c. 24, Sched. B, s. 2 (1); 2017, c. 2, Sched. 8, s. 5.”

24Section 4 of the Limitations Act states that a proceeding shall not be commenced in respect of a claim after the second anniversary of the day on which the claim was discovered.

25Section 6 of the Limitations Act states:

“The limitation period established by section 4 does not run during any time in which the person with the claim,

(a) is a minor; and

(b) is not represented by a litigation guardian in relation to the claim.”

Analysis

26I am not bound by Tribunal decisions; however, I distinguish Smai from the present matter because the central issue in Smai was with respect to the applicant’s ability to bring an application before the Tribunal for a denied benefit, pursuant to s. 56 of the Schedule. Section 56 of the Schedule is definitive in that it imposes a two-year limitation on claimants commencing a claim for a denied benefit before the Tribunal. The Tribunal in Smai held the limitation period was preserved for minors by way of s. 6 of the Limitations Act.

27In my view, s. 32 of the Schedule operates in an entirely different way. While s. 32(1) states an applicant must notify the respondent within seven days of the accident, it also states “as soon as practicable after that day”. Moreover, while s. 32(5) of the Schedule states that an applicant shall submit a completed and signed OCF-1 to the insurer within 30 days after receiving the application forms, s. 34 of the Schedule offers a relief for non-compliance – that being a reasonable explanation.

28Put another way, while the Limitations Act applies to the Tribunal in order to expand access to accident benefits, in my view, the general limitation period under s. 4 of the Limitation Act does not apply to s. 32 of the Schedule. This is because s. 32 does not prescribe a definitive limitation to submit a claim with an insurer for accident benefits, an insurer is not a “court” per s. 2 of the Limitation Act, and applying for accident benefits with an insurer is not the same as bringing an application for a denied benefit before the Tribunal. Thus, the insurer’s response to a claimant’s application for accident benefits is what would trigger the limitation period pursuant to s. 4 of the Limitations Act.

Does the applicant have a reasonable explanation for the delay?

29I find that the applicant has not provided a reasonable explanation for her delay in submitting an OCF-1.

30The applicant appears to argue that her reasonable explanation for not applying for benefits between the date of her mother’s accident to the date she turned 18 is because she was a minor with legal incapacity to apply for same. I agree with the applicant’s position that the Tribunal has held that minors and dependant family members are afforded a relaxed standard when assessing delays. However, I disagree with the applicant’s position that she is not required to provide a reasonable explanation, “as there has been no delay in applying for accident benefits.”

31While I am bound by the principles in Tomec which highlights the consumer protection mandate of the Schedule, the applicant must still provide a reasonable explanation for a delay in applying for benefits. I accept that it would be unreasonable to expect a minor to independently assert their rights and to apply for accident benefits before they reach the age of majority. However, to rely on a ‘limitation period’, where the limitation period in question is not applicable to the circumstances, is not a satisfactory reasonable explanation.

32In other words, despite the applicant turning the age of majority in December 2022, it is unclear why the applicant submitted an OCF-1 on November 14, 2024, nearly two years after her 18th birthday. The applicant submits that after her mother’s passing in June 2023, she obtained legal advice and filed the OCF-1 in November 2024. The applicant does not make submissions as to why it took over a year from the date of her mother’s passing to obtain legal instruction with respect to applying for accident benefits. Moreover, while the applicant submits that s. 32(1) of the Schedule does not apply to an applicant suffering from a psychological impairment, it is unclear from the applicant’s submissions as to how, or in what way, her psychological impairments prevented her from applying for accident benefits between the age of 18 to when the OCF-1 was submitted to the respondent for consideration.

33For the sake of completeness, I distinguish the Tribunal decisions relied on by the applicant in Applicant, A minor by his litigation guardian v. CAA Insurance Company, 2025 CanLII 55808 (ON LAT), and M.O. v. Jevco Insurance Company, 2020 CanLII 63561 (ON LAT). In Applicant, A Minor v. CAA, the applicant was directly involved in the accident, the respondent was aware the applicant was involved in the accident, and the applicant was still a minor when they applied for accident benefits. In the present case, the applicant’s psychological impairments derived from her mother’s involvement in a motor vehicle accident, and she was over the age of majority at the time she applied for accident benefits.

34Similarly, I distinguish M.O. from the present case because in M.O., the applicant was a minor who sustained injuries as a result of an accident, and the Tribunal found that the insurer failed to take action under s. 32 of the Schedule. I agree with the respondent that, in the present matter, it could not have known about the applicant’s alleged psychological impairment prior to the submission of the completed OCF-1. The applicant has not directed me to evidence to support that the respondent was made aware of the applicant’s alleged psychological impairments as a result of her mother’s accident. In my view, noting that a claimant has dependents on an OCF-1 is not enough – on its own – to trigger the obligations under s. 32(2) of the Schedule.

35Given the foregoing, I find that the applicant has not provided an explanation that is credible or worthy of belief, therefore, there is no need to assess the reasonableness of the explanation. In other words, the first principle of K.H. is a threshold that must be met in order to engage the other principles. It is incumbent upon the applicant to provide evidence that supports her position. In my view, she has not.

36Pursuant to s. 55(1)1 of the Schedule, an insured person may not apply to the Tribunal if they have not notified the insurer of the circumstances giving rise to the benefit or has not submitted an application for the benefits within the times set out in the Schedule.

CONCLUSION AND ORDER

37The applicant failed to submit the application for benefits (OCF-1) within the time prescribed in the Schedule.

38The applicant is barred from proceeding with her application pursuant to s. 55(1) of the Schedule. The Tribunal shall vacate any date that has been scheduled for the substantive issues hearing.

39The application is dismissed.