By Lawrence Elkhinovich
Introduction
In Al-Masri v. TD General Insurance Company (2025 ONLAT 24-012855/AABS-PI), the Licence Appeal Tribunal (“LAT”) addressed the issue of claimants seeking to revisit settlements made pursuant to the Statutory Accident Benefits Schedule (“SABS”). Ulana Pahuta found in this case that the LAT did not have jurisdiction to consider the validity of a past settlement because the settlement funds were not returned in accordance with section 9.1(8) of Regulation 664 to the Insurance Act.
The Facts
The applicant, Ameed Al-Masri, was involved in a motor vehicle accident on April 30, 2010. On October 4, 2013, Al-Masri signed a Settlement Disclosure Notice (“SDN”) and a Full and Final Release, reflecting a full and final settlement of $90,000 for all past and future benefits. More than a decade later, on October 17, 2024, Al-Masri applied to the LAT for a catastrophic impairment determination, and to revisit entitlement to further benefits. The insurer, TD General Insurance Company, argued that the agreed-upon 2013 settlement was valid. TD relied upon section 9.1(8) of Regulation 664, arguing that it prohibited Al-Masri from applying to the LAT to challenge the prior settlement, without first returning the $90,000.
Legal Framework / Case Law
Section 9.1 of Regulation 664 is central to this case, as it sets out the following:
- s. 9.1(2): Requires that the insurer must provide the insured with a signed written disclosure notice outlining the terms of the settlement.
- s. 9.1(3): The disclosure notice must include the insurer’s offer, available benefits, and the insured’s right to cancel the settlement within two business days by notifying the insurer and returning any funds received.
- s. 9.1(8): Restricts a person from applying to the LAT in relation to their settlement unless they return the settlement funds.
- s. 9.1(10): Clarifies that a settlement can only legally limit an insured person’s right to apply to or appeal a decision from the Licence Appeal Tribunal if the insurer complied with s. 9.1(2) and (3) and either the settlement was made at least one year after the accident or the insured had already started the LAT process and participated in a case conference
The Tribunal’s Decision
The LAT concluded that it lacked jurisdiction to rule on the validity of the settlement because Al-Masri had not returned the $90,000 settlement funds received. Although Al-Masri alleged that the settlement was invalid because key parts of the settlement documents were left blank and later filled in after signing, the LAT held that any such concerns could only be addressed after the settlement funds were returned. The LAT also rejected Al-Masri’s reliance on Opoku v. Pal, 1999 CanLII 19913 (ONSC), noting that the regulatory framework in place at the time of that decision was significantly different. In particular, the version of Regulation 664 that applied in Opoku did not include a provision like section 9.1(8), which now expressly prevents a claimant from applying to the LAT without first returning settlement funds.
Implications for Insurers
This decision emphasizes that insurers are protected under the current legal framework, so long as the technical requirements of Regulation 664 are properly followed during settlement. In addition, the ruling reinforces the requirement that settlement funds must be returned before a challenge to a settlement can proceed.
Lawrence Elkhinovich is summer student at ZTGH and the author of this blog. If you have a question about this decision or a similar file, please contact Lawrence at [email protected] or Jen at [email protected].
