The case landed at Ontario's Licence Appeal Tribunal after an accident victim was injured in a March 22, 2023 automobile collision and sought statutory accident benefits from Security National Insurance Company. Both sides agreed income replacement benefits were payable at $400 per week. What remained in dispute was whether the insurer unreasonably withheld or delayed those payments, and whether interest was owed on the overdue amounts.
The timeline mattered. The claimant's short-term disability payments stopped, and by two letters dated June 5, 2024, the applicant told Security National about the stoppage, said an IRB recalculation was required, and enclosed pay statements and the disability decision letter. A follow-up went out on June 26, 2024. The tribunal found no evidence the insurer responded to either. The first recalculated payment, $8,800.00, did not arrive until November 7, 2024 - about five months after notice.
Adjudicator Amar Mohammed treated that gap as the heart of the case. Under section 10 of Regulation 664, the tribunal can award up to 50 per cent of benefits payable where an insurer unreasonably withholds or delays payment. The governing standard, drawn from the Plowright decision, asks whether the insurer's conduct was "excessive, imprudent, stubborn, inflexible, unyielding or immoderate."
Mohammed found it was. The insurer, described as a sophisticated party, received clear notice that the offset had ceased, along with supporting documents, yet did not communicate an interim position, request clarification, make a section 33 request, or pay promptly. Later payments arrived in roughly 10-week intervals - $4,276.76 on December 10, 2024, $4,504.79 on February 14, 2025, and $4,864.92 on February 19, 2025 - which the adjudicator said undercut the insurer's claim that it had resumed regular weekly payments.
Weighing the factors, the tribunal called the length of delay and the insurer's blameworthiness aggravating. Vulnerability also counted against the insurer: a progress report noted the claimant faced severe financial hardship and had depleted most of his savings. But there was no evidence of medical or service-access harm, no significant advantage gained from the delay, and the recalculated benefits were ultimately paid using an expert report both sides accepted. Those points pulled the award down.
The result was a 10 per cent award, calculated on the principal benefits withheld plus interest under section 51 of the Schedule and compound interest under section 10 of Regulation 664. The adjudicator rejected the applicant's attempt to fold interest into the base amount, warning that doing so would double-count.
The insurer had also tried to strike the award claim, arguing the applicant failed to provide proper particulars under the case conference order. That failed too. The tribunal found a detailed calculation chart gave the insurer fair notice of the case it had to meet.
The decision was released June 24, 2026.
