Ontario's Licence Appeal Tribunal (LAT) is facing mounting scrutiny from plaintiff-side lawyers and advocacy groups after new data showed claimant success rates in auto accident benefits disputes have fallen to single digits, even as major reforms to the province's no-fault regime approach.
The tribunal, which has had exclusive jurisdiction over statutory accident benefits (SABs) disputes since 2016, was intended to deliver faster, simpler and more consistent outcomes than the courts.
According to a report from The Canadian Press, lawyers now argued it has become an increasingly difficult venue for injured motorists seeking benefits such as treatment funding and income replacement.
A report commissioned by the Ontario Trial Lawyers Association (OTLA) and released earlier this year found that, among fully adjudicated SABs decisions, applicants were successful in just 8% of cases released in 2024, down from 11% in 2023 and 33% in 2016, the LAT’s first year handling these disputes. Insurers won 74% of 2024 decisions, with the remainder split.
OTLA said the trend raises “important questions about balance, transparency and whether the tribunal is fulfilling its legislative mandate to provide a fair, accessible dispute resolution process for injured Ontarians.”
Toronto-area lawyer Meghan Hull Jacquin, who represents accident victims at the LAT, said many clients are deterred by the prospect of a lengthy fight with low odds of success and no ability to recover legal costs, even if they win. “Why would somebody put themselves out there … when the odds are so clearly stacked against them?” she said.
Tribunals Ontario, which oversees the LAT, rejects the suggestion that outcomes are skewed.
Spokesperson Veronica Spada said the LAT receives 16,000 to 17,000 new files a year and that roughly 96% of closed cases are resolved without a final written decision, through settlements, withdrawals or other mechanisms. Focusing only on the small subset of fully adjudicated matters “is working from an incomplete picture,” she said.
She also pointed to the tribunal’s record on appeal, noting that about 74% of accident benefits decisions reviewed by Ontario’s Divisional Court in recent years have been upheld, which she said reflects “the rigor and soundness” of LAT decision-making.
The Attorney General’s office declined to comment and referred questions to Tribunals Ontario.
Ontario’s auto system provides two tracks for injured people: tort actions against at‑fault drivers and no‑fault SABs paid under every auto policy. Since 2016, all SABs disputes have been funneled to the LAT’s Automobile Accident Benefits Service, which is funded by assessments on the insurance industry rather than general tax revenue.
When responsibility shifted from the courts, the government said decisions would typically arrive in 60 to 90 days and that many claimants could navigate the process without lawyers. Nearly a decade on, those expectations are being questioned.
Personal injury and disability lawyer Nainesh Kotak said some applicants still wait more than two years from filing to final decision, despite Tribunals Ontario announcing in October 2023 that it had cleared a backlog of accident benefits cases. Delays, he said, can push costs onto the public health system and social programs when treatment is postponed and injured people are unable to work.
Critics also cited structural issues. Reconsideration requests are typically assigned to the same adjudicator who heard the case, reducing the chance an error will be identified. The tribunal does not award costs, leaving successful applicants to shoulder their own legal fees, while insurers spread litigation expenses across large portfolios.
Adjudicators come from varied backgrounds and may not have legal training or deep insurance expertise, although Tribunals Ontario says all receive targeted onboarding and ongoing education, according to the report.
The LAT’s independence has come under the spotlight in several Divisional Court rulings. The court has overturned accident benefits decisions where adjudicators relied on expert reports that were never tested in cross-examination, and in one case found a “reasonable apprehension of lack of independence” where a draft decision was reviewed by a supervisor before release, despite no request for input.
Spada said adjudicators are independent decision-makers who must base rulings solely on the facts and the law, and that any attempt to influence outcomes would be “absolutely inappropriate.”
Nonetheless, Toronto-area lawyer Imtiaz Hosein is seeking to bring alleged institutional bias issues before the Supreme Court of Canada. His client, pedestrian Lucia Derenzis, was denied income replacement benefits and a catastrophic impairment designation by the LAT.
In seeking reconsideration, she tried to file an affidavit from a former adjudicator turned whistleblower describing internal instructions and bulletins, including guidance to deny motions from parties labeled “difficult” or “high conflict.” The tribunal ordered the affidavit destroyed; the Divisional Court upheld that decision but summarized its contents in a public ruling.
Hosein argued that limiting scrutiny of such allegations risks leaving “a cloud about the integrity of the tribunal itself and of our general justice system.”
The debate over LAT performance is intensifying ahead of sweeping changes to Ontario’s accident benefits package set for July 1, 2026.
Under new rules, only medical, rehabilitation and attendant care benefits will remain mandatory. Income replacement, non‑earner, caregiver, housekeeping, death and funeral and several other benefits will become optional add‑ons. A costing report prepared for the Financial Services Regulatory Authority of Ontario (FSRA) estimates the shift to à‑la‑carte benefits will cut average mandatory premiums by about 5%, but will also transfer more risk to individuals and public programs if motorists decline coverage and are later injured.
Brokers and consumer advocates have warned that the reforms could leave more people underinsured and increase reliance on the tort system, Employment Insurance and Ontario Works when accidents disrupt income. They also question whether modest savings justify the complexity of explaining optional benefit tiers to clients.
For insurers, the LAT remains a crucial line of defense against over‑utilization and fraud in a high‑cost auto market, supported by an industry‑funded model and a solid record at the Divisional Court. The combination of slimmer standard benefits and a challenging dispute forum makes coverage advice more central as renewals approach 2026.
Whether the tribunal can maintain confidence among claimants, the bar and the industry while managing high volumes and a changing legislative landscape is likely to remain a key question as the reforms roll out, the report said.
