In Ontario, disputes over denied statutory accident benefits are decided by the Licence Appeal Tribunal, not the courts. You start by filing an application with the tribunal, attend a case conference, and if the dispute does not resolve there it proceeds to a written or oral hearing. A denial is not the final word, and denials can be overturned when challenged with proper medical evidence. The deadline to dispute a denial is strict and runs from the insurer's refusal, so a denial letter should be acted on promptly.
The LAT decides these disputes, not the courts
If your insurer denies a statutory accident benefit, you cannot sue them in court over it. Ontario sends every accident benefits dispute to the Licence Appeal Tribunal, an administrative tribunal usually called the LAT.
This surprises people. The court system still handles your lawsuit against an at-fault driver, but the fight with your own insurer over treatment funding or income benefits happens at the tribunal.
The two proceedings run separately. A denial at your insurer's desk does not touch your tort claim, and your tort claim does not resolve the denial.
How a LAT dispute actually unfolds
It starts with an application to the tribunal setting out which benefits were denied and why the denial is wrong. The insurer files a response.
The first real event is a case conference, where a tribunal member works through the issues with both sides and explores settlement. Many disputes resolve at this stage.
If it does not settle, the dispute proceeds to a hearing, either in writing or orally. The tribunal member weighs the medical evidence and decides whether the benefit is payable.
Why a denial is not the final word
A denial is the insurer's opinion, and it usually rests on an examination arranged and paid for by the insurer. It is not a final ruling on your condition.
Tribunal members weigh the insurer's examination against the records of practitioners who have followed the patient over time, and a thorough treating record can be compelling. A denial that looked solid in the insurer's letter often looks thin next to a properly assembled medical record.
The work is in the preparation. Reports from your family doctor, specialists and treatment providers, gathered and presented deliberately, are what turn denials around.
What the recent reform changed
Ontario reformed accident benefits recently. Medical, rehabilitation and attendant care benefits remain mandatory in every policy, while income replacement, non-earner and caregiver benefits became optional coverages.
For newer accidents, what you can claim and dispute depends on what was in the policy when it was bought. Reading the certificate of insurance is now the first step in assessing any denial.
The deadline is strict
The clock to dispute a denial starts running from the insurer's refusal, and the deadline is strict. The tribunal has some discretion to extend it, but that is never safe to rely on.
There are better reasons not to wait. Gaps in treatment weaken the medical record, evidence goes stale, and the denied benefit stays unpaid the whole time the letter sits in a drawer.
Deadlines that apply to you
These are the dates that end claims. Check them first.
Tell your own auto insurer about the collision as soon as you reasonably can, and no later than seven days.
Statutory Accident Benefits Schedule, O. Reg. 34/10, s. 32(1)
Once the insurer sends you the application package, the completed application for accident benefits (the OCF-1) is due back within 30 days.
Statutory Accident Benefits Schedule, O. Reg. 34/10, s. 32(5)
Ontario changed its auto accident benefits on July 1, 2026.
Financial Services Regulatory Authority of Ontario, changes to Statutory Accident Benefits coverage effective July 1, 2026 · in force 2026-07-01
Questions we get every week
No. Ontario law sends statutory accident benefits disputes to the Licence Appeal Tribunal, while the courts handle lawsuits against an at-fault driver.
You are allowed to represent yourself, but the insurer will arrive represented, and these disputes turn on medical evidence and the wording of the benefits schedule. Most people are better served with counsel who works in this system regularly.
The tribunal has limited power to extend time in some circumstances, but relief is never guaranteed. Get advice immediately rather than assuming the door is closed.
They are separate proceedings. Accident benefits come from your own insurer regardless of fault, and disputing a denial does not prevent you from pursuing a tort claim.
Where this applies
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