Larmond v. Onlia Insurance Company, 2026 ONLAT 24-006504/AABS
Background
The applicant was involved in a motor vehicle collision on November 15, 2022 and sought accident benefits from Onlia Insurance Company, pursuant to the Statutory Accident Benefits Schedule (SABS).
Following her application for benefits, Onlia placed the applicant in the Minor Injury Guideline (MIG) and denied attendant care and various treatment plans based on same.
The applicant applied to the License Appeal Tribunal (LAT) on May 23, 2024 to dispute her MIG categorization, denied treatment plans, denied attendant care and also sought interest and a special award pursuant to s. 10 of O. Reg. 664 for all of the denied benefits.
A case conference was held on September 19, 2024. Over two months later, the applicant was removed from the MIG on November 26, 2024. Following this removal from the MIG, the respondent approved the applicant’s claim for attendant care in the amount of $3,000 per month on December 2, 2024 and the treatment plans were approved between December 2, 2024 and March 20, 2025.
As the denied treatment plans, and attendant care were subsequently approved, the applicant proceeded with her application solely to determine the issues of interest and a special award.
The applicant argued that she was entitled to interest and a special award on all denied treatment plans and attendant care as the respondent had improperly kept the applicant in the MIG for two years, despite her medical documentation clearly demonstrating that her injuries did not fall within the MIG. She further argued that she was only removed from the MIG after the case conference, despite there being no apparent change in circumstance or new evidence.
The respondent argued that the applicant was removed from the MIG based on a technicality. Specifically, the respondent argued that one of the treatment plans was denied 11 business days after its submission and because of the late denial, the applicant was removed from the MIG pursuant to s. 38(11) of the SABS. The respondent further argued that the technicality was not discovered until counsel was retained for litigation and that the oversight does not amount to misconduct warranting a special award under s. 10.
The LAT’s Findings
The LAT found that the applicant was entitled to a special award and interest. Even if the applicant was removed from the MIG on a technicality after counsel was retained, Adjudicator Malach found the respondent failed to explain why it took two months after the case conference to do so, especially when counsel had been retained more than four months prior to the removal from MIG. The respondent then failed to immediately address many of the denied benefits.
The respondent did not explain why it was removing the applicant from the MIG until its submissions in the hearing. While there is no statutory requirement to elaborate, Adjudicator Malach found the respondent’s failure to explain led the applicant to continue with her application and make assumptions about the reason for her MIG removal.
Even after the MIG removal, the respondent’s continued delay in approving and paying the treatment plans in dispute, resulted in an unreasonable withholding and delay in payment of a greater tier of benefits.
The LAT awarded the applicant a 15% special award pursuant to s. 10 of O. Reg. 664.
Adjudicator Malach applied the 15% award to $24,215.60, representing the total value of the treatment plans originally in dispute and 15% to $62,580, representing the total value of attendant care between March 15, 2023 and December 2, 2024.
The special award totalled $13,019.34.
Adjudicator Malach also ordered that interest be paid on the treatment plans, pursuant to s. 51(4) of the SABS, from the date of the application to the date each treatment plan was subsequently approved, calculated at the prejudgement interest rate described in subsection 128(3) of the Courts of Justice Act.
Reconsideration Decision
Larmond v. Onlia Insurance Company, 2026 ONLAT 24-006504/AABS-R
Following receipt of the LAT’s decision, the applicant sought reconsideration on the issues of pre-application interest and interest on the special award, as the decision was silent on both issues.
The applicant argued that the LAT made an error by failing to allow any interest to accrue on the award itself, as it only ordered a lump sum. Specifically, the applicant submitted that s. 10 of O. Reg. 664 includes a mandatory interest component, “at the time of the award together with interest on all amounts then owing to the insured.”
The respondent argued that the interest component on the special award is not mandatory but rather discretionary. Specifically, the respondent submitted that the change in legislative wording from “shall award” to “may award” a lumpsum and interest was meant to add discretion to the LAT’s award-granting powers.
Vice-Chair Craig Mazerolle held that the LAT did err by not providing for any interest with its order for an award. He opined that the wording of s. 10 suggests interest will accrue on the award. He further opined that the word “may” in s. 10 of O. Reg. 664 relates to the issuance of the award itself, not the interest. If the LAT uses its discretion to order a special award, the interest component for the award is mandatory.
Ultimately, the LAT varied the decision at paragraph 42(i), to read as follows:
“The respondent is required to pay an award of $13,019.34, which is 15% of the total of the treatment plans and attendant care benefits approved, plus any interest payable under s. 10 of O. Reg. 664.”
As a result of the reconsideration decision, the respondent is responsible for interest on the special award at the rate of 2% per month, compounded monthly, from the time the benefits first became payable under the SABS.