05/19/2026
Retroactive Claims for Accident Victims
In a major Divisional Court decision, Ontario accident victims just received powerful new protection for retroactive non-earner benefits.
The case involved a cyclist (Ms. Clouthier) who was struck by a car in February 2020 and suffered severe injuries — skull fractures, traumatic brain injury, and months of hospitalization during COVID-19 visitor restrictions.
Accident benefits forms were submitted in July 2020. The insurer paid non-earner benefits only from that date forward and denied the earlier period, strictly relying on s. 36(3) of the SABS.
The Licence Appeal Tribunal agreed with the insurer. On appeal, the Divisional Court ruled in favour of the claimant and sent the matter back to the LAT.
Key Holding:
Section 34 of the SABS (the “reasonable explanation” safety valve) does apply to the timing requirement in s. 36(3). A rigid interpretation that denies benefits to someone medically incapable of filing on time is unfair and contrary to the purpose of the accident benefits scheme.
This decision is a game-changer for seriously injured claimants dealing with incapacity, hospitalization, cognitive impairment, or delayed forms.
At our firm, we stay on top of these important developments so we can fight for the full benefits our clients deserve.
If you or someone you know has had early accident benefits denied due to timing or paperwork issues, we can help. Drop a comment or send us a message for a free consultation.
