Licence Appeal Tribunal File Number: 25-011838/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:
Frederick Louttit
Applicant
and
Motor Vehicle Accident Claims Fund
Respondent
PRELIMINARY ISSUE HEARING DECISION AND ORDER
ADJUDICATOR:
Lisa Holland
APPEARANCES:
For the Applicant:
Pamela Vlasic, Counsel
For the Respondent:
Greg Specht, Counsel
Heard:
By Way of Written Submissions
OVERVIEW
1Frederick Louttit, the applicant, was involved in an automobile accident on June 28, 2024, and sought benefits pursuant to the Statutory Accident Benefits Schedule- Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, Motor Vehicle Accident Claims Fund (“MVACF”), and applied to the Licence Appeal Tribunal-Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
PRELIMINARY ISSUE IN DISPUTE
2The Case Conference Report and Order (“CCRO”) dated January 8, 2026, identifies the preliminary issue as:
i. 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 by the Schedule?
3The parties’ submissions on this preliminary issue address the applicant’s failure to notify the respondent of his intention to claim accident benefits pursuant to section 31(1) of the Schedule. The facts of this matter, which are not in dispute, support that the applicant did not notify the respondent of the accident and of his intention to claim accident benefits until he submitted his OCF-1 to the respondent on July 15, 2025.
4Neither party filed a motion to amend the preliminary issue. Based on both parties’ submissions, I accept that it was the parties’ understanding that the preliminary issue to be decided is in relation to the notification requirement of section 32 of the Schedule, rather than the submission of his application (section 32(5)).
RESULT
5The applicant did not notify the respondent of the accident within the timeline prescribed by the Schedule and he has provided a reasonable explanation for the delay.
PROCEDURAL ISSUES
6In his preliminary issues hearing submissions, the applicant submits that he disagrees with the CCRO in not allowing him to submit affidavit evidence regarding his explanation for the delay. The applicant did not bring a motion to amend the CCRO, nor does he seek a remedy for an affidavit to be included as evidence in this hearing. The applicant argues that there should be an adverse inference drawn against the respondent for failing to obtain the applicant’s evidence at an examination under oath, and for its objection at the case conference to the applicant entering affidavit evidence at the preliminary issues hearing.
7In its reply submissions, the respondent argues there is no causal link to the applicant’s difficult past as an Aboriginal person and his delay in notifying the respondent in a timely manner. In addition, the respondent argues that the applicant has not sought to vary or amend the CCRO regarding affidavit evidence, and he has had the opportunity to present his evidence in his submissions. The respondent submits that it does not owe the applicant an examination under oath as a means for him to meet his onus to provide a reasonable explanation for the delay.
8I find that there is no procedural unfairness to the applicant because the respondent has not objected to the admissibility of the applicant’s evidence, and he has had the opportunity to provide evidence and a reasonable explanation for the delay in notifying the respondent of his involvement in the accident in his submissions.
ANALYSIS
9Section 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 date.
10Once an insurer receives notice of an applicant’s intention to apply for statutory accident benefits, the insurer must provide the applicant with the appropriate OCF forms, a written explanation of the benefits available, information to assist the person in applying for benefits and information on the election relating to specified benefits, if available (s.32(2)). Pursuant to s.32(5) of the Schedule, the applicant must then submit a completed and signed application for benefits to the respondent within 30 days after receiving the forms.
11Section 34 states that if the insured person does not comply with the time limits prescribed under Part VIII of the Schedule, which includes s. 32, the insured person may still be entitled to benefits if they have a reasonable explanation for the delay. The interpretation of “reasonable explanation” is guided by Horvath and Allstate Insurance Company of Canada, 2003 ONFSCDRS 92, and was reiterated in K.H. v. Northbridge, 2019 CanLII 101613 (ON LAT). The guiding principles are summarized as follows:
a. An explanation must be determined to be credible or worthy of belief before its reasonableness can be assessed.
b. The onus is on the insured person to establish a “reasonable explanation”.
c. Ignorance of the law alone is not a “reasonable explanation”.
d. 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.
e. The lack of prejudice to the insurer does not make an explanation automatically reasonable.
f. As 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.
The applicant has provided a reasonable explanation for the delay
12The applicant was involved in an accident on June 28, 2024. He was a pedestrian struck by an unknown driver. The applicant relies on the clinical notes and records (“CNRs”) of Anishnawbe Health, which provide information regarding his move from northern Ontario to Toronto two months before the accident. The applicant submits that in Toronto, the applicant was living in an assisted living facility for first nations seniors, and he requires assistance with his activities of daily living due to a visual impairment and mobility concerns.
13The applicant submits that the CNRs of University Health Network and Anishnawbe Health reference the applicant’s accident-related complaints. On June 29, 2024, he attended the emergency department at Toronto General Hospital with complaints of accident-related right lower leg pain. On July 9, 2024, he further attended his doctor, Dr. Adrian Miguel regarding a subsequent hospital visit on July 7, 2024 for right ankle pain. Dr. Miguel referred the applicant for physiotherapy for his right leg pain, and he indicates that the radiological examination of the right leg was negative for fractures. Dr. Miguel referred the applicant to Afiya Spine and Pain Clinic on July 31, 2024 after the accident regarding his right leg and low back pain.
14The respondent submits that it was not notified of the accident or of the applicant’s intention to apply for accident benefits until approximately one year after the accident. The OCF-1 dated July 15, 2025 was submitted over a year later by his legal representative. The respondent points to a letter dated August 26, 2025, from the applicant’s legal representation which provides an explanation for the delay that he is unsophisticated and unfamiliar with automobile insurance and the process for claiming accident benefits. The respondent submits that ignorance of the law and level of sophistication do not explain the applicant’s failure to retain counsel to submit an application. The respondent submits that these factors are not reasonable explanations for the delay.
15The applicant submits that he does not own a vehicle, and he is unfamiliar with automobile insurance. The applicant submits that once it became clear that his condition was not improving, he was advised by an advocate to seek legal representation. The applicant submits that he did provide an explanation for the delay and the respondent did not fully investigate his claim at an examination under oath to obtain his subjective evidence.
16I find that the applicant has had an opportunity to provide a reasonable explanation for the delay. The applicant submits that he had no knowledge of the law or what to do in case of an accident. He had no insurance, or driver’s licence, had no computer or access to the internet, and he is dependent on others for his personal care and activities of daily living.
17The first guiding principle in Horvath sets out that an explanation must be determined to be credible or worthy of belief before its reasonableness can be assessed. I agree with the respondent that the explanations provided are vague and/or unsupported by the evidence. While I am sensitive to the applicant’s lack of sophistication, as per K.H., ignorance of the law alone is not a reasonable explanation. The evidence shows that the applicant sought medical attention shortly after the accident, and he does not explain why he failed to notify the respondent at that time. However, I find it credible and worthy of belief that an unsophisticated party may not realize that an uninsured person can apply to MVACF for accident benefits in circumstances where they were hit as a pedestrian.
18I am persuaded that as an unsophisticated party, the applicant would not have known that he could submit an application for accident benefits to MVACF in a situation where he was struck by an unidentified driver as a pedestrian. It was not until he discussed the accident with his advocate and obtained legal advice that he realized he could make a claim to the MVACF.
19The applicant relies on Shaver v. Onlia Insurance Company, 2023 CanLII 58481 (ON LAT) where the Tribunal found that an unsophisticated person would not have known he could make a claim for accident benefits where he was struck as a pedestrian. The Tribunal found the hardship to the applicant outweighed any prejudice to the respondent because the applicant sustained serious injuries in the accident and he underwent surgeries for bilateral ankle fractures, and required the use of a wheelchair, crutches and a cane.
20The respondent argues the facts in Shaver are distinguishable, because here, the applicant obtained minimal medical attention, and the prejudice to the respondent outweighs any hardship to the applicant.
21Taking into account the principles of K.H., I find that the applicant’s explanation for his delay in notifying the respondent of the accident and of his intention to claim accident benefits is credible and worthy of belief. Although ignorance of the law alone is not sufficient, I accept that an unsophisticated person with no knowledge of automobile insurance would not have known they could make a claim to the MVACF for injuries caused by an unidentified driver.
22I am not persuaded that the delay in this matter has caused prejudice to the respondent in fulfilling its obligations to investigate other insurance available to respond to the claim, and conduct contemporaneous medical assessments, especially where it did not take the opportunity to conduct an examination under oath. The applicant has provided evidence that the accident was investigated by the police at the time, and he has functional limitations which may be affected by his accident-related injuries. I am satisfied that the hardship to the applicant as a result of the respondent’s denial of his claim outweighs any prejudice to the respondent. In these circumstances, I find that it would be equitable to relieve against the consequences of the applicant’s failure to comply with the time limit.
23For these reasons, I find that the applicant has met his onus to establish a reasonable explanation for his delay.
Section 55
24Pursuant to s. 55(1)1 of the Schedule, an insured person shall not apply to the Tribunal under subsection 280(2) of the Insurance Act if the insured person has not notified the insurer of the circumstances giving rise to a benefit or has not submitted an application for the benefit within the time prescribed in s. 32.
25As outlined above, I find that the applicant did not notify the respondent within the timelines prescribed by the Schedule, however, he has provided a reasonable explanation for the delay. Accordingly, I find that the applicant is not statute-barred from proceeding with his application before the Tribunal.
ORDER
26For the reasons set out above, I find:
i. Although the applicant did not notify the respondent of the accident within the timeline prescribed by the Schedule, he has provided a reasonable explanation for the delay.
ii. The applicant may proceed to the substantive issues hearing.
Released: June 1, 2026
Lisa Holland
Adjudicator