Geico processed an Ontario resident's accident claim under the province's benefits regime for months — then tried to walk it back. A tribunal said no.
In a decision released March 26, 2026, the Ontario Licence Appeal Tribunal ruled that Geico Insurance Company is estopped from denying that Colleen M. Morrissey qualifies as an insured person under Ontario's Statutory Accident Benefits Schedule. The finding turns entirely on how Geico handled the claim from the start.
Morrissey, an Ontario resident, was struck by a Geico-insured vehicle while walking in Salina, New York, on July 5, 2022. She was hospitalized with multiple fractures and reported ongoing pain. She did not carry her own motor vehicle liability insurance at the time.
Within weeks of the accident, Morrissey filed an Application for Accident Benefits with Geico. The insurer accepted it. Its adjuster confirmed she was assuming carriage of the claim under section 64(21) of the Schedule, sent Morrissey an information package outlining benefits available under the regulation, included excerpts of its provisions, and even linked to the Schedule on the Ontario E-Laws website. The adjuster told Morrissey she could dispute any denial before the Tribunal.
From there, Geico approved treatment plans, paid non-earner benefits, referenced the $65,000 non-catastrophic medical and attendant care benefit limit, and approved attendant care under section 19 of the Schedule. By late September 2022, it had confirmed ongoing non-earner benefits of $185 per week.
Then, on October 7, 2022, Geico changed its mind. In an email to Morrissey's lawyer, the insurer said she was not entitled to Schedule benefits and would instead receive $50,000 USD under New York's personal injury protection obligations. Yet even after that reversal, Geico kept paying non-earner benefits and treatment invoices well into early 2023 — before advising in February 2023 that the $50,000 USD was used up.
When Morrissey later applied for catastrophic designation, Geico's response was blunt: "I am very confused by your OCF 19, Application as this is not a SABS claim."
Adjudicator Trina Morissette was not persuaded. Applying the Supreme Court of Canada's three-part test for estoppel by convention from Ryan v. Moore, she found that both parties had operated under a shared understanding that the Schedule governed the claim. Morrissey relied on that understanding and incurred treatment expenses exceeding $26,000 beyond the non-catastrophic limit. Allowing Geico to walk away from its own representations, the adjudicator found, would be unjust.
The Tribunal also pointed to section 131(1)(b) of Ontario's Insurance Act, which provides that an insurer's conduct can excuse an insured's compliance obligations where that conduct reasonably leads the insured to believe that compliance is excused in whole or in part, and the insured acts on that belief to their detriment. The Divisional Court has confirmed this provision codifies estoppel and falls within the Tribunal's jurisdiction.
While the adjudicator acknowledged Morrissey does not technically meet the statutory definition of insured person under the Schedule, estoppel by convention bridged the gap. Morrissey was deemed an insured person, and the case will now proceed to a hearing on the substantive benefit claims.
