Does the LAT Have Jurisdiction to Grant Interim Benefits to Insured Persons? The LAT says it does NOT

By Justine O. Lee Young Nov 12, 2021

*This decision was overturned*

In Gilani v. Travelers Insurance Company of Canada, 2021 ONLAT 19-009248/AABS, Adjudicator Paul Gosio found the LAT lacks the jurisdiction to grant interim benefits. 

Governing Rules

The governing approach for statutory interpretation was established by the Supreme Court of Canada in Bell ExpressVu Limited Partnership v. Rex, 2002 SCC 42. The SCC established that the words of an Act are to be read in their entire context and in their grammatical and ordinary sense harmoniously with the scheme of the Act, the object of the Act, and the intention of Parliament. One of the essential objectives of this approach is to avoid “absurd” results. An interpretation is considered to be “absurd” if it leads to ridiculous or frivolous consequences, is illogical, incoherent or is incompatible with other provisions. The rules of statutory interpretation apply equally to regulations and per the Ontario Legislation Act, 2006,  legislation should also be given a liberal interpretation.

History of the Proceedings

The Applicant in this case was injured in an accident in 2015 and was denied certain benefits by the Insurer. A hearing proceeded on March 9, 2021 to determine whether the Applicant was catastrophically impaired. In the interim, the Applicant brought a motion requesting interim benefits during the adjournment of the hearing. The Applicant argued these benefits were necessary to ensure he receives the required care to prevent him from endangering his life, health, family or members of the public. The Respondent opposed the motion, arguing the Tribunal does not have the authority to grant such an award.

Reasoning/ Takeaways

The jurisdiction of a tribunal must be found within a statute or regulation. As a statutory tribunal, the LAT can only exercise power delegated to it by or under its enabling legislation.  In the absence of an applicable regulation regarding interim benefits orders, the Tribunal has no jurisdiction to make such an order.

S. 280(5) of the Insurance Act, specifically contemplates regulations to provide for interim orders. However, there are no such regulations currently in force. In fact, deliberate amendments to the Insurance Act by legislators in 2016 intentionally limited the Tribunal’s jurisdiction to grant orders for interim benefits without a regulation first being adopted.

While s.16.1 of the  Statutory Powers Procedure Act (“SPPA”) states that a tribunal may make interim decisions and orders, Adjudicator Gosio stated that a liberal interpretation of the SPPA must not override the intent of an enabling statute. The practices around these discretionary powers can be set out in the rules, as long as those rules are consistent with the SPPA and other statutes.  The issue with interim benefits, however, is that they are not specifically mentioned anywhere in the LAT Act, or elsewhere, to provide clarity on the legal criteria for awarding interim benefits.

Adjudicator Gosio therefore decided that interim benefits cannot be set out by the LAT’s rules alone; it clearly requires a regulation. Since such a regulation does not exist, the Tribunal cannot read in any discretionary power on the issue of interim benefits. Section 16.1 of the SPPA should not be interpreted so broadly that the act of limiting the Tribunal’s discretionary powers would be overlooked.

Decision

To suggest s.16.1 of the SPPA provides the Tribunal with broad discretionary power to order interim benefits would not be consistent with other legislation indicating that such powers do not exist. Adjudicator Gosio therefore dismissed the Applicant’s motion for interim benefits.

Justine Lee Young is the author of this blog and member of the LAT practice group. If you have a question about this decision or a similar file, please contact Justine at 416-777-5221.

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