Kayly Machado

In the recent decision of Flerova and Economical, 2025 ONLAT 22-01455/AABS the Applicant made no arguments on whether their impairments fell outside of the MIG, instead arguing the validity of each of the denials pursuant to s.38 of the SABS. Our office was able to successfully defend each and every denial reaffirming the recent LAT decision of Golden v Economical Mutual Insurance Company, 2024 CanLII 2672 (argued by my colleague Colin MacDonald) which confirms that there is no statutory or common law obligation for the insurer to list the Applicant’s specific injuries in a denial, rather, the insurer need only provide medical or other reasons.

They say “you never forget your first”. The decision in Lacnit and Economical was the first file that was ever assigned to me following my call to the bar and the first file I ever handled from opinion through to decision making this decision incredibly special to me. As new lawyers, we must remind ourselves to walk before we can run and to always start with the basics. This decision is a perfect example of that. Although the Applicant reported both physical and psychological complaints to his treating practitioners and assessors, these complaints were not supported by the records of his family doctor. Post-accident complaints of neck and shoulder pain reported 7 months post-accident were not attributable to the accident. While it’s always fun to brainstorm new and interesting technical defences, sometimes simply relying on the medical records is enough to secure a great result for the client. More importantly than the basics, a strong team contributed to this win. Special thanks to Jason Zhang for preparing the document brief and Kadey Schultz, LL.B. LL.M. CRM for all of her guidance along the way.

LAT Finds No Settlement Absent Meeting of the Minds The LAT has confirmed that a mutually agreeable signed release and SDN can be considered essential terms of a settlement in an accident benefits settlement. In Robinson v AIG Insurance, 2024 ONLAT 23-0088800/AABS the parties reached an “agreement in principle” as to the monetary amount of a settlement, but could not agree on the terms of the release – specifically whether AIG’s insured could be included in the release. The emails from AIG’s counsel were clear that a mutually agreeable worded release was an essential term of the settlement. When settlement discussions fell apart, the Applicant signed the Settlement Disclosure Notice, unilaterally crossing out the reference to the signed release. No release had ever been executed by the Applicant at the time of the hearing. Co-Adjudicators Rebecca Hines and Dagmara Szczudlo concluded that Section 9.1(3) of Regulation 664 is clear that both a signed release and SDN are required components of a settlement agreement in an accident benefits settlement. They determined that the Applicant’s unilateral amendment to the SDN was evidence that the release was an essential term of the settlement that had not been agreed upon by the parties. As the Applicant had not signed an SDN or release in the form agreeable to both parties, there was no meeting of the minds on the essential terms and therefore no enforceable settlement. The Applicant requested the alternative relief of an Order requiring removal of all references to AIG’s insured from the release. The LAT concluded that its authority was limited to a determination as to whether the parties reached a binding settlement and that there was no authority of the LAT to dictate the terms of the settlement. This is a significant development in the evolution of settlement enforcement cases at the LAT which had previously only addressed enforcement of settlements where the Applicant had passed away prior to execution of the settlement documents.