Belair Insurance Company Inc. was hit with a costs order after a tribunal called its claim filings "blatantly untrue" - even as it successfully fought off most of the disputed treatment plans.
The Ontario Licence Appeal Tribunal decision, released August 4, 2026, resolved a statutory accident benefits dispute stemming from a motor vehicle accident on April 22, 2024. The applicant sought coverage for occupational therapy, speech-language pathology, a psychological assessment, a cognitive assessment, a vocational assessment, and yoga therapy - all denied or partially denied by Belair.
Adjudicator Tami Cogan upheld the insurer's position on most of the disputed treatment plans. The applicant was not entitled to the disputed occupational therapy or speech-language pathology plans, nor to a psychological assessment which the adjudicator accepted as duplicative of an already-approved plan. She was, however, entitled to a cognitive assessment worth $2,070, a vocational assessment worth $2,200, and yoga therapy worth $3,832.24, the adjudicator finding each reasonable and necessary given the applicant's diagnosed injuries.
Belair also avoided a special award under section 10 of Regulation 664, which allows the tribunal to order an insurer to pay up to 50 per cent of benefits owing where it unreasonably withheld or delayed payment. Cogan found the applicant had not proven that threshold was met.
Where Belair ran into trouble was conduct during the tribunal proceeding itself, not the benefits decisions. Cogan determined the insurer served an addendum report from its own examining physician just one day before Belair filed its own submissions, without explanation or a request for an extension. That breached a requirement to disclose evidence within 60 days of the case conference, and she found it prejudiced the applicant's ability to obtain a rebuttal report.
More seriously, Cogan found that Belair's submissions repeatedly and strenuously claimed the applicant had failed to attend any insurer's examinations before April 4, 2025. That claim, the tribunal found, was false: the applicant had in fact attended a neuropsychological assessment in January 2025 that continued in April, an occupational therapy assessment in May, and a general physician's assessment in June. Belair's own submissions, the decision noted, omitted its own occupational therapy examiner's attendance record entirely.
Cogan ultimately found Belair had acted unreasonably and in bad faith, concluding its conduct interfered with the tribunal's ability to run a fair and efficient process and supported an award of costs under Rule 19 of the Licence Appeal Tribunal Rules. Although the applicant sought $3,390 in costs, Cogan awarded $500, representing half a day, which she found reasonable to draft the reply submissions responding to the misconduct.
Cogan's decision kept the benefit findings and the costs award separate. Belair prevailed on the disputed occupational therapy, speech-language pathology, and psychological assessment plans, and avoided a special award under section 10. It did not avoid the costs order tied to its own conduct in the submissions.
