Aviva cannot rely on an insured's "no injuries" phone reply to skip sending accident benefit forms, an Ontario tribunal ruled.
In Adjei v. Aviva Insurance Company of Canada, a preliminary decision released on April 30, 2026, the Licence Appeal Tribunal found that Aviva Insurance Company of Canada fell short of its obligations to a driver injured in a March 10, 2024 crash - and that her nine-month delay in filing the formal application did not shut the door on her claim.
Vice-Chair Trina Morissette held that a single phone conversation, in which the driver said she was not hurt, did not discharge the insurer's duty to send out the OCF-1 application form and explain the available benefits.
The driver, Leticia Adjei, told Aviva's adjuster two days after the accident that she had no injuries. The insurer's log notes captured the exchange in three short lines - no injuries to her, none to the other party, no dashcam. The two never discussed her health again, and Aviva never mailed an accident benefits package.
Adjei did see her family doctor, who referred her to physiotherapy. She was also still claiming benefits from an earlier accident, a March 10, 2023 rear-end collision that was also insured by Aviva. It was only in December 2024, after a case conference on that earlier file, that she submitted an OCF-1 for the second crash - almost nine months after it happened.
Aviva pushed back hard. Adjei knew the process, the insurer argued, having filed an OCF-1 within weeks of her 2023 accident and having legal representation throughout. Aviva pointed to Rahman v. TTC Insurance Company Limited and Raveendran v. Coseco Insurance Company. Across follow-up calls between March 13 and April 16, 2024, the insurer noted, she never raised any injury.
The tribunal sided with Adjei, leaning on the Divisional Court's 2025 ruling in Hussein v. Intact Insurance Company. Hussein recognizes that accident victims are vulnerable and that insurers carry a positive obligation under section 32(2) of the Statutory Accident Benefits Schedule to provide the application form, a written explanation of benefits, and information to help the insured apply.
Aviva argued Hussein gives insurers an out once they ask about injuries and hear "no." Morissette disagreed. Asking about injuries at first notice helps clarify which benefits an insured may want, she wrote, but it does not erase the duty to send the OCF-1 package. Injuries, she noted, can take days or weeks to surface.
Because Aviva never sent the forms, the 30-day filing clock under section 32(5) never started. Morissette also found Adjei's explanation - that she assumed no additional paperwork was needed because no package ever arrived - credible.
Any prejudice to Aviva, the tribunal added, was largely of its own making, and was eased by Adjei's signed Reciprocal Release Authorization allowing the insurer to cross-reference both claim files.
Adjei's claim now heads to a substantive hearing on her entitlement to benefits.
