The License Appeal Tribunal is a tribunal in Ontario that adjudicates applications and disputes concerning compensation claims amongst other things. This is the tribunal your matter would go to if you are in a dispute with your own insurance company over entitlement to accident benefits.

Accident benefits are the no fault benefits available to anyone injured in a car accident in Ontario, or if an Ontario insured is injured in a car accident in another jurisdiction. Accident Benefits include income replacement benefits and benefits for treatment and rehabilitation amongst other things.

When a car accident victim applies to the insurance company to access these benefits they can be denied. If the benefits are denied the injured person can dispute that denial by filing an application to the LAT.

It was recently reported that one adjudicator employed at the LAT from May 2017 to November 2022, had applied for and accepted a position with Aviva, one of the larger auto insurers in Ontario, in June 2022. The adjudicator then remained employed by the LAT until November 2022, despite already accepting the position at Aviva, rendering more than 10 decisions in favour of insurance companies, with 4 favourable decisions for Aviva.[1]

Since then, it has also been reported that three additional LAT adjudicators have gone to work for Aviva, Intact and Difinity Insurance raising further questions of bias and conflicts of interest at the LAT.[2]

There is a large power imbalance when it comes to car accident victims claiming benefits from the insurance company. The insurer holds all the power, they are the ones who determine if you are “eligible” for benefits and will often find ways to deny claims. In addition, they have the power to request current medical records, past medical records and the ability under the legislation to send you to hired medical examiners. When this system fails, and it does, those injured in car accidents are denied entitlement to things like income replacement benefits, physiotherapy, and other forms of treatment.

The only recourse a car accident victim has is to file an application to the LAT to have an adjudicator make the final determination. This requires the same level of impartiality as the courts, given this is a quasi-judicial tribunal. For the system to work it is imperative to have impartial, unbiased adjudicators. The recent discovery of such impartiality is disheartening. It is imperative that the LAT ensure there are adequate policies and procedures in place to address impartiality on an ongoing basis.

[1] https://www.lawtimesnews.com/practice-areas/insurance/lawyers-group-wants-probe-into-adjudicator-deciding-insurance-cases-after-accepting-job-with-aviva/378486

[2] https://www.insurancebusinessmag.com/ca/news/breaking-news/ontario-lawyers-auto-insurance-tribunal-allegations–at-least-three-insurers-hired-adjudicators-456477.aspx#:~:text=Insurance%20News,-By%20Gia%20Snape&text=OTLA%20has%20claimed%20to%20have,investigation%20into%20these%20people%20moves