Co-operators has kept a repeat catastrophic impairment claim shut down, after Ontario's accident benefits tribunal refused to reopen a case it already barred.
The Licence Appeal Tribunal released its reconsideration decision on July 16, 2026, dismissing an applicant's bid to revisit an earlier ruling that blocked her from pursuing a catastrophic impairment designation. The dispute stems from a September 1, 2018 automobile accident and a claim for benefits under Ontario's Statutory Accident Benefits Schedule.
The story reaches back years. In an initial decision dated October 20, 2023, the tribunal found the applicant had not sustained a catastrophic impairment, barred her from income replacement benefits, and awarded attendant care benefits of up to $905.34 per month. It denied the medical and rehabilitation benefits she claimed. The applicant sought judicial review, and on June 2, 2025 the Divisional Court dismissed the application and upheld the initial decision.
The applicant then filed a fresh application on March 27, 2025, again seeking a catastrophic impairment determination. Co-operators, the respondent insurer, raised a preliminary objection: res judicata, the principle that a matter already decided cannot be relitigated. In a preliminary issue decision released March 10, 2026, the tribunal agreed and barred the application. The reconsideration request followed.
For claims professionals, the reasoning is the takeaway. To reopen a barred claim, the applicant needed fresh evidence powerful enough to conclusively overturn the original result. Vice-Chair Craig Mazerolle found she had not produced it.
Much of the argument turned on competing impairment reports. In the first hearing, the applicant relied on an assessment scoring 40% whole person impairment under criterion 7. A newer report placed that figure at 20% under criterion 7, while adding a marked impairment under criterion 8. The Vice-Chair said he could not reconcile a decreased rating with a gained impairment as a material change in the applicant's circumstances.
The applicant also pointed to hospital admissions and continued suicidal ideation after the 2023 ruling. The tribunal found those records consistent with the pattern already considered in the initial decision, not a conclusive change. It cited case law warning that letting dissatisfied parties bring fresh evidence after a poor result would "make a mockery of the principle of finality in litigation."
The applicant further argued the tribunal had breached procedural fairness by barring affidavit evidence from her medical team during the written preliminary hearing. Mazerolle rejected the argument, noting she had agreed to the hearing format and that written preliminary hearings are established practice. A separate bid to introduce new testimonial evidence also failed, because she had not shown it could not have been obtained earlier.
The tribunal dismissed the reconsideration request, along with a related $1,000 costs claim.
