The Statutory Accident Benefits Schedule (SABS) is consumer protection legislation. However, when the wording of a section is unambiguous and mandatory, it must be interpreted in a straightforward manner and not in a way that renders it meaningless. That includes section 32, which sets out the timelines for reporting injuries from an accident and submitting an application for accident benefits.
S. 32(1) of the SABS requires that, when a person intends to claim accident benefits, they must notify the insurer of that intention “no later than the seventh day after the circumstances arose that give rise to the entitlement to the benefit, or as soon as practicable...” If an accident benefits claim is not submitted in a timely manner, then it can be barred pursuant to s. 55 of the SABS. However, a claim can still proceed if a person has a reasonable explanation for their delay.
S. 32(1) has historically been treated as unambiguous and applied in a straightforward manner by adjudicators at the Licence Appeal Tribunal (LAT).
In the decision of Jakupovic v Intact Insurance Company (2023 CanLII 122890 (ON LAT)), the Applicant was involved in an accident in February 2019. He made a claim for vehicle damage immediately after the accident, but did not notify Intact that he was injured and intended to claim benefits until December 2020. The Insurer denied his application on the basis that it was too late. The Applicant argued that Intact should have made further inquiries about whether he was injured and provided him with an accident benefits package to inform him about accident benefits and the claim process. However, the Adjudicator rejected this argument and found as a fact that the Applicant did not report any injuries to Intact or advise of an intention to claim benefits within the timeframe required by s. 32(1). As such, his claim was barred. The original decision was upheld on reconsideration and was then appealed to the Divisional Court.
The Divisional Court overturned the Adjudicator’s findings on the basis of consumer protection and read in a requirement for an insurer to assume that a claimant intends to pursue benefits, rather than the claimant having to advise of this intention. The Divisional Court stated that people who have motor vehicle accidents are in a vulnerable position, particularly in the period immediately following an accident, and that seven days is a very short notice period. It concluded that the interpretation of s. 32(1) applied by the Adjudicator at first instance “undermines the consumer protection purpose of the SABS”, and stated that it ignored that most consumers do not know what coverage they have after an accident. The Court also concluded that the Applicant met the notice requirement in s. 32(1) by simply reporting the accident, and went on to state that “A reasonable insurer would assume that an insured who has been in an accident intends to access all the benefits available to them under their policy.”
This dispute went up to the Court of Appeal, and they emphatically disagreed with the Divisional Court’s conclusion. The Court of Appeal stated that “s. 32(1) is not ambiguous. It requires a person who is involved in an accident and who intends to claim benefits to notify the insurer of their intention to do so. This is plain, clear language and it is mandatory.” The Court of Appeal went on to note that the Divisional Court erred by focusing on the consumer protection aspect of the SABS, rather than applying the established principles of statutory interpretation, which required it to determine whether s. 32(1) had more than one meaning. The Court of Appeal found it did not, which should have been the end of the analysis.
The Court of Appeal also stated that it was an error to read into the provision that an insurer should assume that every person in an accident intends to claim accident benefits. The Court concluded that reversing the existing trigger and requiring insurers to initiate accident benefits claims for every accident led to an absurd result and rendered s. 32(1) meaningless.
The Court of Appeal also noted that the Divisional Court’s findings of fact, specifically that the seven days was “a very short notice period”, claimants who have been injured “are in a vulnerable position”, and “the average consumer would [not] be familiar with the entitlement to damages and the role of the SABS”, exceeded the scope of the appeal.
This decision is very important for insurers, as it confirms that there is no positive obligation on an insurer to presume that all people in accidents have suffered injuries. In fact, the onus remains with the insured to tell the insurer that they were injured in a timely manner, and only at that time is the insurer required to send an AB package.
Click the following link to read the Court of Appeal decision: Jakupovic v. Intact Insurance Company, 2026 ONCA 651 (CanLII)
