An Ontario tribunal has barred a claimant from pursuing accident benefits, ruling Definity Insurance Company met its statutory duty to inform him of filing deadlines.
The Licence Appeal Tribunal released its preliminary issue decision on May 26, 2026 in Noor v. Definity Insurance Company, 2026 CanLII 51022 (ON LAT). The dispute turned on whether Mohamed Ali Noor had a reasonable explanation for submitting his Application for Accident Benefits, the OCF-1, more than four months past the regulatory window.
Noor was involved in a motor vehicle collision on December 3, 2023 and notified Definity three days later. On December 12, 2023, the adjuster emailed him the application package and flagged the 30-day filing window. The adjuster had been unable to leave a voicemail on calls attempted December 6 and again on December 12.
A telephone discussion took place on January 16, 2024. Adjuster log notes record that Noor said he was waiting to speak with his doctor, who in turn was waiting on imaging. The adjuster confirmed he could complete the forms himself, the package was resent at his request, and a new deadline of January 26, 2024 was set.
The OCF-1 did not arrive until May 28, 2024. Definity asked Noor for a Statutory Declaration explaining the delay and followed up in July and August. He provided the declaration on September 17, 2024, citing poor health and an extreme personal situation. The insurer denied the claim on October 18, 2024.
Adjudicator Nadia Mauro framed the central question as whether the insurer had complied with section 32(2) of the Statutory Accident Benefits Schedule, which requires insurers to give applicants the forms and information needed to apply. She found the December 12 email was clear, warned the applicant that late submission could jeopardize his entitlement absent a reasonable explanation, and included a hyperlink to the Financial Services Regulatory Authority of Ontario.
That communication, combined with the January 16 phone call, was "sufficient to discharge the insurer's obligation" under section 32(2).
Mauro also weighed the Ontario Superior Court's recent ruling in Hussein v. Intact Insurance Company, 2025 ONSC 842, which recognized that consumers in the immediate aftermath of a collision are vulnerable and that insurers carry a positive obligation to inquire and assist. The adjudicator noted Definity's written warnings, two deliveries of the OCF-1, and direct phone guidance satisfied the obligation here.
On the question of a reasonable explanation, Mauro held that Noor's account did not clear the threshold of credibility set out in K.H. v. Northbridge General Insurance Company, 2019 CanLII 101613 (ON LAT). His family physician's clinical notes did not reference the application or accident benefits, and he did not return to the practice until June 3, 2024 - after the package had been filed.
The application was dismissed under section 55(1) of the Schedule.
