Jurisdiction over statutory accident benefits exclusively vested in Licence Appeal Tribunal

Framing action against insurer as bribery or conspiracy doesn't change jurisdiction: Ontario court

Jurisdiction over statutory accident benefits exclusively vested in Licence Appeal Tribunal

The Ontario Superior Court of Justice has no jurisdiction over disputes arising from statutory accident benefits because exclusive jurisdiction is vested on the province’s License Appeal Tribunal, the Ontario Court of Appeal has ruled.

In Yang v. Co-operators General Insurance Company, 2022 ONCA 178, the plaintiff, Celia Yang, was injured in a car accident. She claimed damages amounting to $150 million. She eventually took issue with how her insurer, General Insurance Company, handled her claim so she brought an action against it.

Yang’s action was ultimately dismissed because the Superior Court determined that it lacked jurisdiction over the subject matter. The judge also ruled that Yang’s asserted causes of action had no chance of success and that her pleadings were “so frivolous, scandalous, and vexatious that they should be struck without leave to amend.”

Under s. 280 of the Ontario Insurance Act, the License Appeal Tribunal has exclusive jurisdiction over disputes arising from statutory accident benefits. To such an extent, the Superior Court is deprived of jurisdiction.

Yang alleged several causes of action, but both the motion judge and the appellate court found that the crux of her complaints was a dispute about how her insurer handled her claims under the Statutory Benefits Schedule. She alleged that her insurer coerced the respondent health care practitioners into “staging” multiple examinations and preparing false reports. She further claimed that Co-operators breached her privacy and withheld or destroyed relevant documents.

Yang attempted to frame her action as one in bribery, conspiracy, breach of privacy, breach of contract or breach of fiduciary duty, but the court said it did not alter the substance of her claim, which centered on the Co-operators’ alleged efforts to circumvent the Statutory Benefits Schedule. The court said that this fell squarely within the exclusive jurisdiction of the License Appeal Tribunal, to the exclusion of the Superior Court.

Relying on prior jurisprudence, Yang argued that because she had already settled with her insurer, the tribunal had been removed from its jurisdiction as it was only empowered to adjudicate disputes between an insurer and the insured.

The appellate court disagreed and said that Yang freely chose to settle with her insurer, and the fact that she could not now independently seek damages against each of the other parties did not oust the Tribunal’s jurisdiction over the claim. In the end, the appellate court dismissed the plaintiff’s appeal.

 

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