If you are injured in a car accident in Ontario, you are entitled to receive statutory accident benefits (“SABS”). This is true even if you are at fault for the accident. SABS can include, among other things, coverage for medical treatment, attendant care, and income replacement benefits.
Despite your entitlement to receive these benefits, insurers often deny a claimant’s request to be provided with them. When benefits are denied, you are not without recourse. You can appeal the denial to a tribunal called the Licence Appeal Tribunal (the “LAT”). A lawyer is not required to represent a person through the appeal process but having one makes the process much easier.
What is the Licence Appeal Tribunal (LAT)?
The LAT is an adjudicative body established by the Government of Ontario under the Licence Appeal Tribunal Act, 1999. It operates independently from the government, which means it is intended to be an impartial forum for resolving disputes.
In addition to automobile insurance disputes, the LAT also handles appeals related to driver’s licence suspensions and claims under the Motor Vehicle Accident Claims Fund.
The appeal process:
The process at the Licence Appeal Tribunal generally follows these steps:
- Filing an application: Individuals must submit an application to the LAT which outlines the denials they are appealing. The application form has to be served on every other party involved (typically only the insurance company) and then filed, along with a certificate of service, with the LAT. There is a non-refundable filing fee of $106.00.
- Response to application: Upon receipt of the application, the LAT will assign a file number and ask the other party (again, typically the insurance company) to respond. The responding party then completes their own form.
- Case conference: Once in receipt of an application and the response to that application, the LAT will schedule a case conference. This case conference is a one-hour call between the parties and an adjudicator from the LAT. The LAT adjudicator will explore settlement potential with the parties. If a settlement cannot be reached, the adjudicator will discuss hearing considerations.
- Hearing: If the matter does not settle at the case conference, a hearing date will be scheduled. Hearings can occur in writing, by teleconference, by videoconference, or by any mix of these method. Following the case conference, all parties will receive a Notice of Hearing from the LAT which outlines the date, time, and hearing format. Typically, the hearing is within 60-90 days of the case conference.
- Decision: The adjudicator issues a written decision outlining their findings and reasons for the decision based on the evidence presented and the applicable law.
Conclusion
The Licence Appeal Tribunal plays a very crucial role in addressing disputes regarding statutory accident benefits. In concept, it is a straightforward process, but in practicality it is not always as simple as it seems. If you find yourself in need of assistance, consulting with a legal professional who understands the workings of the Licence Appeal Tribunal can greatly benefit your case and ensure that your rights are protected throughout the process.
If you have questions about the information contained within this article or any other personal injury questions, please contact any member of the Siskinds Personal Injury Department.