The Tribunal dismissed the Applicant’s claim for accident benefits on the basis that he was statute-barred from proceeding.
The Applicant was involved in an MVA on September 14, 2023. He failed to notify Definity of his intention to seek accident benefits until January 25, 2024 which was beyond the 7-day requirement under s. 32(1) of the SABS. The Applicant argued that the delay was reasonable due to language barriers as a recent Ukrainian refugee, difficulty accessing a Ukrainian-speaking physician, and confusion about which insurer to apply to after reporting the accident to his property damage insurer, Certas Home and Auto Insurance Company (“Certas”). The Applicant relied on the Divisional Court decision of Hussein v. Intact Insurance Company, 2025 ONSC 842 to argue that the claimants were in a vulnerable position and that the SABS is not a document that the average consumer would be familiar with. The Tribunal rejected these arguments, agreeing with the Insurer’s submissions that the Applicant failed to provide a credible and reasonable explanation for the delay, particularly given his ability to navigate the property damage claims process independently. The Adjudicator agreed with the Insurer and found that Hussein was distinguishable from this case, as the Applicant did not report property damage to Definity but to Certas. As such, Definity could not have inquired as to whether the Applicant had sustained injuries in the accident or sent the necessary application forms. The Adjudicator also drew an adverse inference from the Applicant’s failure to produce relevant records from his property damage insurer, which had been ordered at the Case Conference.
As a result, the Tribunal found the Applicant had not provided a reasonable explanation for the delay pursuant to Section 34 of the SABS and therefore, the Applicant was barred from proceeding with the substantive issues in dispute pursuant to Section 55(1)1 of the SABS. The Application was dismissed.
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