An Ontario tribunal has dismissed an accident benefits claim after the applicant waited 311 days to file her OCF-1, citing homeopathy as her reason.
The Licence Appeal Tribunal's preliminary decision in Zill v Definity Insurance Company, 2026 CanLII 48403 (ON LAT), released May 20, 2026, addresses late-notice claims under the Statutory Accident Benefits Schedule.
Ammara Zill was a passenger in a vehicle driven by her husband on September 7, 2024, when a large dog charged and ran into the passenger side. According to her Statutory Declaration, her knee hit the door, her eyeglasses broke, and she felt immediate chest and knee pain, along with headaches and nausea. She could no longer work as a makeup artist after the accident. She had also been involved in a previous accident on December 8, 2021.
Zill notified Definity Insurance Company of the accident on September 9, 2024 - two days later. The adjuster's log noted she reported neck and back pain, said she would attend for treatment, had multiple prior accident benefit claims within the last three years, and already had a lawyer. That same day, Definity emailed her an accident benefits package, warning her that the OCF-1 and OCF-5 had to be returned by October 9, 2024, or her entitlement could be jeopardized. A follow-up email went out on October 2, 2024.
Nothing came back. On February 24, 2025 - 170 days post-accident - applicant's counsel finally contacted Definity. The insurer responded the same day, reminding counsel that the OCF-1 had been due October 9, 2024. The completed OCF-1 was eventually submitted on July 15, 2025 - 311 days after the accident, and 141 days after counsel was retained.
Zill's explanation, provided through her legal representative on August 15, 2025, was that she believed her injuries would resolve with home remedies and homeopathy. Her father is a homeopathic doctor, and she used a heat pad and massager. When the relief proved temporary, she decided to see a chiropractor and pursue a claim.
Vice-Chair Trina Morissette was not persuaded. Applying the framework from Horvath and Allstate Insurance Company of Canada, 2003 ONFSCDRS 92 (CanLII), and K.H. v. Northbridge, 2019 CanLII 101613 (ON LAT), she found the explanation neither reasonable nor sufficient to overcome the statutory deadline. A belief she would get better, combined with interim homeopathic treatment, was not a reasonable explanation for failing to submit the application within the Schedule's timeline.
The prejudice analysis went Definity's way. The insurer argued it had been deprived of the ability to contemporaneously assess Zill, investigate the circumstances, gather medical records, and conduct surveillance in the ten months immediately following the accident - prejudice the adjudicator found was compounded by the unusual circumstances of the accident and the applicant's claim that she had not returned to her self-employment as a makeup artist or her pre-accident activities.
The Tribunal held Zill was barred under section 55(1) of the Schedule from proceeding. The application was dismissed.
