Intact Insurance Company almost tripped over its own filing before it could raise the defence that closed out a years-long accident benefits dispute.
The applicant was involved in an automobile accident on July 19, 2019, and sought statutory accident benefits from Intact after the insurer denied or partially denied nine treatment plans covering chiropractic care, psychological services, and a multidisciplinary assessment. When Intact refused to pay the full amounts claimed, the applicant took the dispute to the Licence Appeal Tribunal. The parties held a case conference on March 16, 2026, and a written hearing on the merits was scheduled for September 18, 2026.
Before that hearing could happen, Intact raised a preliminary issue: the applicant, it argued, had waited too long to dispute the denials. Section 56 of the Statutory Accident Benefits Schedule gives claimants two years from an insurer's refusal to pay a claimed amount to bring a dispute to the Tribunal.
But Intact's own record had a gap. In an April 17, 2026 motion, the insurer admitted it had "inadvertently omitted four letters from the documentation initially submitted" - denial and partial-denial notices for the psychological services plans, dated April 23, 2020, July 19, 2021, December 6, 2021 and November 1, 2022. Intact argued the applicant would not be prejudiced by their late addition, noting three of the four letters were already part of the applicant's own submissions and that the wording of its case had not changed.
The applicant did not respond to the motion, despite being given until April 27, 2026 to file submissions. Vice-Chair Trina Morissette treated that silence as a sign there was no objection, and found the letters caused no prejudice since they were not new information and had already been sent to the applicant when issued. She granted the motion, allowing Intact to rely on the complete set of denial letters going into the limitation analysis.
The applicant argued the denials could not start the two-year clock unless they gave the medical and other reasons required for treatment plan notices under section 38(8) of the Schedule, relying on the Supreme Court's test in Smith v. Co-Operator General Insurance Co. Morissette disagreed, finding that section 56 only requires a clear refusal to pay to trigger the limitation period, and does not import section 38(8)'s notice-content requirements.
Reviewing each of the nine denial letters against the Smith test, Morissette found they were written in plain language an unsophisticated person could understand, identified the treatment plan in question, and set out the two-year deadline to dispute. The applicant filed his Tribunal application on October 30, 2025, which fell after the calculated two-year deadline for every one of the nine treatment plans in dispute.
Morissette found no basis to extend the deadline, since the applicant had not asked the Tribunal to exercise that discretion or addressed the factors that would support doing so. The application was barred in full, closing out the dispute over all nine treatment plans without a hearing on the merits.
