Articles Posted in License Appeals Tribunal

April 1, 2016 was an important date for car accident victims across Ontario. Not because it was April Fools Day. But because on this date, everything to do with hearing and adjudicating accident benefit disputes in Ontario changed.

All accident benefit disputes filed on or after April 1, 2016 which used to be heard at the Financial Services Commission of Ontario were from that point forward heard at the License Appeals Tribunal or LAT for short.

Only around 2 or 3 adjudicators from FSCO transferred over to the LAT, so there was no real continuity or institutional knowledge which had carried over from FSCO to the LAT.

Adjudicators at the LAT were not bound by any precedent set by the years of caselaw developed at FSCO.

There were new shorter time lines which the parties had to deal with. New rules regarding expert reports and expert qualifications.

Costs only awarded in rare circumstances, and when costs are awarded, they are under the low end of the spectrum.

The cost burden shifted significantly to the injured accident victim who has much less money to spend on legal fees than does the insurance company who they are fighting against.

At FSCO the accident victim simply filed for mediation. The cost of filing for mediation was free to the accident victim. If the mediation failed, the accident victim could give up on the case, pay $100 to file for Arbitration, or elect to sue in Superior Court.

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When you’ve been wronged and want to seek justice; you sue.

It’s sounds simple and it ought to be.

Trouble is, when it comes to accident benefit disputes following a car accident in Ontario, you can’t sue anymore. Your right to sue in Court and have your case heard before a Judge were taken away from you. That means that you can’t sue.

Understanding this concept for many innocent car accident victims is really hard to understand. It seems unfair and it is.

Instead of suing in the Courts, accident victims who are seeking compensation for their accident benefit claims follow a car accident are REQUIRED to apply to the License Appeals Tribunal Automobile Accident Benefit Service (LAT AABS) or simply know as the LAT.

The LAT is a Tribunal run by the Province of Ontario. It’s a strange place with its own unique set of rules, procedures and adjudicators.

It’s not uncommon for disputes to be resolved at a Tribunal instead of Courts. We see it in all sorts of places like the Human Rights Tribunal, Workplace Safety and Insurance Board, Ontario Land Tribunal etc.

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Everyone loves a good acronym. It’s fun to guess what the letters in the acronym stand for…..or don’t.

Here are a few non legal examples:

BRB Be right back

GTG Got to Go

LOL Laugh Out Loud

Here are a few legal examples of acronyms which personal injury lawyers in Ontario see everyday:

IRB Income Replacement Benefit

NEB Non Earner Benefit

SOC Statement of Claim

ACB Attendant Care Benefit

Here is one acronym which has been in use for over 20 years in legal circles which will soon go extinct:

FSCO Financial Services Commission of Ontario

The Financial Services Commission of Ontario is a regulatory agency of the Ontario Government that use to regulate insurance, pension plans, loan and trust companies, credit unions, caisses populaires, mortgage brokers, and co-operative corporations in Ontario. FSCO regulated or registered:

• 316 insurance companies
• 7,022 pension plans
• 98 credit unions and caisses populaires
• 57 loan and trust corporations
• 1,216 mortgage brokerages
• 2,754 mortgage brokers
• 12,275 mortgage agents
• 184 mortgage administrators
• 4,630 accident benefit service providers
• 1,764 co-operative corporations
• 54,128 insurance agents
• 5,911 corporate insurance agencies
• 1,740 insurance adjusters 

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If you’ve been hurt or injured in a car accident, you are entitled to accident benefits from your own car insurer. These accident benefits are NOT damages for pain and suffering; nor are they compensation intended to make you whole for your attendant care, income loss, housekeeping claim, or loss of guidance, care and companionship with immediate family members.

Accident benefits are intended to help the injured accident victim get better following a car accident. They are also intended to supplement, to some form, for their income loss (up to $400/week) and attendant care (up to $3,000/month for non-catastrophic claims, and up to $6,000/month for catastrophic claims).

The problem lies herein. The insurance company supplying those accident benefits is typically your own car insurer; even though you or your insurer may have not even caused the car accident (hence the term no-fault benefits). But the accident benefit insurer gets to act as Judge, Jury and Executioner all in the same breath when determining which accident benefits they will pay, and which accident benefits they won’t pay.

If an insurer paid our on each and every claim, without contesting or opposing a treatment plan, they would not be nearly as profitable as they are today. Insurance companies are publicly traded corporations. Profits not only matter, but matter each and every quarter to ensure that the stock price increases for their share holders. Check the TSX for your favourite car insurers, which include but aren’t limited to Intact Insurance IFC.TO; Co-Operators General Insurance Company CCS-C; and Aviva PLC to name a few. The more money which insurers pay out to accident victims, the less money they get to retain in profit. That ultimately hurts their bottom line, and their share performance struggles on public stock exchanges.

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