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The Court of Appeal of Ontario Affirms the Exclusive Jurisdiction of the License Appeal Tribunal over Statutory Accident Benefits Disputes

By Athina Ionita

The Court of Appeal in Yang v. Co-operators General Insurance Company, 2022 ONCA 178,confirmed the exclusive jurisdiction of the License Appeal Tribunal (LAT) over disputes concerning Statutory Accident Benefits (SABs).

The decision underlying the appeal concerned a motor vehicle accident, where the plaintiff claimed damages in the amount of $150 million.[1] Specifically, the plaintiff’s claim concerned how the automobile accident insurer, Co-operators General Insurance Company, administered her claims for SABs. The plaintiff sued several Co-operators employees, multiple SABs service providers, various doctors and others. The defendants brought a motion to strike the plaintiff’s statement of claim.

Justice Perell heard the defendants’ motion and dismissed the plaintiff’s action for a number of reasons, including that the pleading was scandalous, the Court did not have subject matter jurisdiction over her claim and the plaintiff had not plead a legally tenable cause of action against any of the defendants.

The plaintiff appealed, arguing that the motion judge erred in holding that the Superior Court lacked jurisdiction over the subject matter of her claim and in striking her pleadings under both Rule 21.01(1)(b) and Rule 25.11.

The Court of Appeal found that the motion judge made no error in interpreting and applying s. 280 of the Insurance Act, R.S.O. 1990, c. I.8, which grants the LAT exclusive jurisdiction over disputes in respect of SABs. The appeal panel affirmed that s. 280(3) also deprives the Superior Court of jurisdiction.

The crux of the appellant’s complaints in her statement of claim relate to her insurer’s handling of her claims under the Statutory Accident Benefits Schedule. She alleges that Co-operators and that the other respondents conspired to coerce the respondent health care practitioners into “staging” multiple insurer examinations and preparing false reports.

The Court of Appeal states that the appellant’s statement of claim concerns the respondents’ alleged efforts to circumvent the Schedule and that framing the action as one in bribery, conspiracy, breach of privacy, breach of contract, or breach of fiduciary duty did not alter the substance of her claim.[2]  

The appellant argued that, because she has settled with her insurer and is pursuing an action against the insurer’s employees and others, s. 280 was not a bar to her claim since the LAT is empowered only to adjudicate disputes between an insured and an insurer. The Court of Appeal rejected this argument, stating that the appellant’s claim concerns the way in which she was assessed for SABs under the Schedule, which is squarely within the LAT’s mandate. The appellant chose to settle with her insurer and the fact that she cannot now independently seek damages against each of the other parties does not oust the Tribunal’s jurisdiction over the subject matter of the claim.[3]

Even if the action was not barred by s. 280 of the Insurance Act, the motion judge’s refusal to grant leave to the appellant to amend her pleadings is a discretionary decision entitled to deference.[4]

The appeal was dismissed and the exclusive jurisdiction of the LAT to decide all disputes concerning SABs was strongly confirmed.

[1] Yang v. Co-operators General Insurance Company, 2021 ONSC 1540.

[2] Para 7 of Appeal decision.

[3] Para 10 of Appeal decision.

[4] Para 11 of Appeal decision.