An Ontario tribunal ruled that Echelon General Insurance Company's own delays undercut its bid to block a motorcyclist's accident benefits claim.
The Licence Appeal Tribunal, in a decision released August 25, 2026, found Echelon failed to properly provide accident benefit application forms to a claimant for more than seven years after his 2015 motorcycle collision with a TTC bus. That failure let his benefits claim proceed even though his completed application arrived more than eight years after the accident.
Echelon argued the claimant should be barred from pursuing benefits because he did not submit a completed application for benefits, known as an OCF-1, until January 24, 2024, past the 30-day window set out in the Statutory Accident Benefits Schedule. Adjudicator Ulana Pahuta disagreed, finding Echelon had not properly discharged its own duty to provide the application package until May and July 2023.
Echelon mailed the claimant an OCF-1 in January 2016, but the letter was returned as undeliverable weeks later due to a wrong address. The insurer left two voicemails and sent a follow-up letter before closing the file in March 2016. Those efforts fell short, Pahuta found, since Echelon knew the address was wrong and stopped trying just over two months after the accident. She distinguished an earlier tribunal decision Echelon relied on, in which an insurer was found to have met its obligations simply by mailing forms to the address on file - unlike Echelon, which had clear notice its mailings were not reaching the claimant.
The file then went quiet until 2019, when a law clerk called on the claimant's behalf; the adjuster's callback found the line busy, and no further attempt followed for nearly four years. Echelon received a catastrophic impairment psychiatric assessment in November 2022 but did not send a fresh OCF-1 to the claimant's updated address until July 2023 - eight months after receiving that report.
Only at that point, Pahuta ruled, had Echelon met its obligations under section 32(2) of the Schedule. She also found the claimant had a reasonable explanation under section 34 for the remaining delay in returning the completed form, pointing to medical evidence of significant psychiatric conditions and cognitive impairment following the accident, including reports that he struggled with motivation and decision-making. An explanation must be credible before its reasonableness is even weighed, she noted, citing both personal circumstances and what a reasonable person would do - a bar the claimant met, without needing to reach a separate dispute over his capacity to instruct counsel.
Pahuta added that Echelon's own letters set shifting deadlines rather than clearly stating the 30-day requirement, and cited the Divisional Court's finding in Hussein v. Intact Insurance Company that accident victims are in a "vulnerable position, particularly in the period immediately following an accident."
The tribunal ordered that the claimant is not barred from proceeding with his accident benefits claim, and closed its file with no other issues remaining in dispute.
