An Ontario tribunal has ruled that Dominion of Canada General Insurance failed to send a legally required benefits package before contesting a claimant's filing deadline.
In a preliminary decision released July 28, 2026, the Licence Appeal Tribunal found that Dominion could not show the applicant missed the notice or filing deadlines under Ontario's Statutory Accident Benefits Schedule, clearing the way for a hearing on the substantive issues.
The applicant was rear-ended in a September 3, 2024 collision and reported it to Dominion the next day. According to adjuster's log notes cited in the decision, he told Dominion on two separate occasions that he had not been injured.
Two days after the accident, Dominion told the applicant he was at fault for the crash and had only one way coverage, meaning he would only have coverage if he was not at fault. The adjuster's log notes from that conversation record that the applicant was "advised there would be no coverage owed on this claim. Confirmed no coverage." A follow-up letter from Dominion the same day stated he had no coverage for the accident, without distinguishing between a property damage claim and an accident benefits claim.
The applicant did not submit his completed OCF-1 application until April 25, 2025. Dominion argued this fell outside the 30-day window in section 32(5) of the Schedule, and that the applicant had no reasonable explanation for the delay.
Vice-Chair Trina Morissette disagreed. She found that once Dominion learned of the accident, section 32(2) of the Schedule obligated it to send the applicant an accident benefits package, including the OCF-1 form and an explanation of available benefits - regardless of his earlier denial of injury. Because Dominion never sent that package until after it received the OCF-1, the 30-day clock under section 32(5) never started.
Morissette found that Dominion's mixed messaging about fault and coverage could reasonably have led the applicant to believe he had no claim at all. A letter from the applicant's counsel attributed part of the delay to his limited English.
Morissette also declined to follow an earlier tribunal ruling that had found an insurer need not provide benefits information where no injury has been reported. She held that the duty to send the accident benefits package is not lifted simply because a claimant initially denies injury, since symptoms may not surface for days or weeks after a crash.
For claims professionals, the ruling confirms that an early denial of injury does not, on its own, excuse an insurer from its duty under section 32(2) to send the accident benefits package. By declining to follow the earlier, more insurer-favourable decision on that point, Morissette leaves two differing interpretations in tribunal case law.
The applicant's claim will now proceed to a hearing on the substantive benefits issues, scheduled for September 18, 2026.
