Full Decision
Adjudicator: Matthew M Létourneau
Counsel for the Appellant: Sylvia Guirguis
Counsel for the Respondent: Peter Yoo and Student-at Law Lee Abraham
HEARD: In Writing February 18, 2019
The Licence Appeal Tribunal (“the LAT”) has determined that it does not have the power nor jurisdiction to award interim benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (the ”Schedule”).
The applicant was involved in a motor vehicle collision on February 21, 2017 and sought benefits pursuant to the Schedule. The applicant was denied certain benefits by the Respondent, Allstate Insurance, and as a result, submitted an application to the LAT.
The applicant’s application was submitted on July 27, 2018. The applicant argued that due to the delays in advancing the matter, over a year between the date of his application for accident benefits and the in-person hearing, he incurred expenses of $18,025 in attendant care services and $9,751.24 in medical treatment during that period. He sought that the Tribunal make an order for interim benefits for the incurred expenses.
The applicant argued that the accident benefit framework provided a broad and sufficient jurisdiction to make a discretionary interim order for benefits.
The applicant noted that the previous practice under the FSCO regime on accident benefits provided for a general discretionary power of making interim orders pursuant to (now repealed) s. 279(4.1) of the Insurance Act. The applicant also relied upon s.16.1 of the Statutory Powers Procedure Act, R.S.O. 1990, c.S.22, (“SPPA”) which permits interim decisions and orders by a Tribunal with a view of ensuring “a just, expeditious and cost-effective determination of every proceeding”. Lastly, the applicant argued that s. 3(2) of the LAT Act, which notes that the Tribunal “has all the powers that are necessary or expedient for carrying out its duties”, gives the Tribunal the appropriate authority to grant equitable relief or to make substantive interim orders, including for interim benefits.
The LAT rejected the applicant’s arguments. The Tribunal held that its powers to make orders with respect to resolving disputes between the applicants and respondents were limited to what is provided for, in the Insurance Act and the Schedule. In particular, s. 280(4) of the Insurance Act states that “the dispute shall be resolved in accordance with the Statutory Accident Benefits Schedule”.
It relied on s. 280(6) of the Insurance Act, which was modified to state that “without limiting what else the regulations may provide for and govern, the regulations may provide for and govern the following:
a. Orders, including interim orders, to pay costs, including orders requiring a person representing a party to pay costs personally.
b. Orders, including interim orders, to pay amounts even if those amounts are not costs or amounts to which a party is entitled under the Schedule.”
The Tribunal also relied on Sarpong v State Farm Insurance, 17-007152/AABS (“Sarpong”), a previous LAT decision that dealt with interim orders. In Sarpong, the Tribunal concluded that unless a regulation is adopted by the legislature pursuant to the Insurance Act giving the Tribunal the power and jurisdiction to issue interim benefits orders, then the Tribunal’s power to do so is not available. The legislature has yet to exercise that power.
The Tribunal also agreed with the respondent that s.16.1 of the SPPA is related to interim procedural orders, rather than substantive ones. The Tribunal noted that the intention of the legislature was clear, to bar the Tribunal from reading-in a substantive provision on other amounts not found in the Schedule.
The Tribunal concluded that it has no jurisdiction to award interim benefits.
