Licence Appeal Tribunal to deal with accident benefit disputes

April 23, 2016, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

LATitude

The LAT has landed and we will all have to hop on and try to enjoy the bumpy ride.  The Licence Appeal Tribunal will now deal with all accident benefit disputes commencing April 1, 2016.  It will significantly transform how disputes are dealt with in Ontario.  The opportunity to litigate an accident benefit dispute has been eliminated (subject to a current constitutional challenge that is ongoing).  The ultimate goal of the new dispute process, the LAT's auto insurance dispute resolution system (AIDRS), brought to you by the Automobile Accident Benefits Service (AABS), is to streamline the dispute resolution process.  It is generally agreed that the resolution process under FSCO had become very time consuming.  The timelines to resolve disputes have become ridiculously long and result in a benefit to the insurer (delay in paying for treatment plans) and harm to the insured (delay in obtaining recommended treatment).  If the LAT is able to deliver on its goal of responding more quickly to dispute applications, then that will certainly be a positive benefit.

The new dispute resolution process will eliminate the mediation step.  The insured files an Application for Arbitration and the insurer responds.  The parties will then complete a case conference summary that will outline documents to be used, witnesses, type of hearing (written, electronic or in person).  All parties will be required to attend a case conference where the arbitrator will deal with preliminary issues like the type of hearing (in person hearings for the most serious matters like catastrophic impairment determination), production issues, the list of witnesses, make any Orders and have settlement discussions.  Once a hearing decision is made there will be a limited right to appeal.

There is some question about whether the LAT will be able to handle the expected volume.   The goal is to resolve most disputes within 5 to 9 months.  The accident benefit dispute process generates a large volume of claims and if the Ontario government puts insufficient resources to the administration of the claims, then a third party service will have to be retained to assist.  I suspect that the insurers are pleased to be out from FSCO, which has generally been viewed as more favourable to accident victims, and starting with a new process that has already indicated that it will not be bound by prior decisions (precedent) at FSCO. 

So what can insured’s expect from the new LAT.  How will the LAT respond to accident benefit claims?   One indicator may be a study (by Canadians for Properly Built Homes) of LAT decisions from 2006 to 2013 under the Ontario New Home Warranty Act.  The study did not show a very positive success rate for homeowners.  The study showed that homeowners only had an 18% success rate.   Will that be an indication of the potential success for insured’s/accident victims?  Through effective representation and advocacy, and the collaboration of legal representatives and treatment providers to fairly present the insured’s case, we can make the system work for the benefit of accident victims.  Keep your seatbelts fastened, the captain is calling for turbulence ahead.

Posted under Accident Benefit News, Automobile Accident Benefits, Car Accidents, Catastrophic Injury, Chronic Pain, Fractures, Pain and Suffering, Treatment

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About Deutschmann Law

Deutschmann Law serves South-Western Ontario with offices in Kitchener-Waterloo, Cambridge, Woodstock, Brantford, Stratford and Ayr. The law practice of Robert Deutschmann focuses almost exclusively in personal injury and disability insurance matters. For more information, please visit www.deutschmannlaw.com or call us toll-free at 1-866-414-4878.

It is important that you review your accident benefit file with one of our experienced personal injury / car accident lawyers to ensure that you obtain access to all your benefits which include, but are limited to, things like physiotherapy, income replacement benefits, vocational retraining and home modifications.

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