Accident Benefits Denied in Ontario? How the Licence Appeal Tribunal Works

After a car accident in Ontario, your own insurer pays statutory accident benefits: income replacement, medical and rehabilitation, attendant care and more. When the insurer denies or stops a benefit, the dispute goes to the Licence Appeal Tribunal (LAT), not to court.

Common reasons benefits are denied

• The insurer says your injuries fall within the Minor Injury Guideline and its funding cap.

• An insurer's examination concluded a treatment plan is not reasonable or necessary.

• Income replacement was stopped because the insurer says you can return to work.

Watch the deadline

In most cases you have two years from the insurer's written refusal to apply to the LAT. Keep every letter the insurer sends you, with its date.

How the process works

You file an application with the LAT. A case conference is held first, where the issues are defined and settlement is explored. If the matter does not settle, it proceeds to a hearing, often in writing or by video. Medical records and expert reports usually decide these cases, so gathering evidence early matters.

Talk to a licensed paralegal

Licensed paralegals can represent you at the Licence Appeal Tribunal. Merisca Legal Services in Thornhill helps accident victims across Ontario dispute denied accident benefits. Call 647 818 3005 to book a consultation. This article is general information, not legal advice.