Accident Benefits Denied in Ontario? What to Do Next
Published
A denial letter from an insurer is a decision you can challenge. Disputes about Ontario accident benefits go to the Licence Appeal Tribunal (LAT).
Common reasons insurers deny or stop benefits
- The injury is placed under the Minor Injury Guideline, which caps medical and rehabilitation funding at $3,500
- A treatment plan is rejected as not reasonable or necessary
- Income replacement or non-earner benefits are stopped after an insurer's examination
- The insurer says forms or documents arrived late or incomplete
- The insurer disputes which policy applies to you, a question with more combinations after the July 2026 reform
Step 1. Read the denial letter carefully
The insurer has to give its reasons and tell you about your right to dispute the decision at the Licence Appeal Tribunal. Note the date on the letter. That date matters for your deadline.
Step 2. Check the 2-year limit
An application to the LAT generally has to be filed within 2 years of the insurer's denial. The clock runs from the denial, not from the accident. Waiting rarely helps: medical records get harder to gather, and benefits stay unpaid while time passes.
Not sure when your 2 years started?
Send us the date on your letter →Step 3. Gather your evidence
Useful evidence includes medical records, reports from your treating doctors, the insurer's examination reports, your OCF forms and proof of income. Reports from your own treating providers carry weight when the tribunal compares medical opinions.
Step 4. Consider asking the insurer to reconsider
Sometimes a short written response with new medical evidence is enough for the insurer to change its decision. This step is optional, and the 2-year limit keeps running while you wait.
Step 5. File with the Licence Appeal Tribunal
The LAT handles accident benefits disputes in Ontario. After an application is filed, the insurer responds, usually within 14 days. The next stage is a case conference, where an adjudicator helps the parties narrow the issues and explore settlement. If the dispute continues, it goes to a hearing, where the evidence is presented and the adjudicator decides. A licensed representative can act for you throughout.
What to avoid after a denial
- Missing an insurer examination you were properly scheduled for
- Stopping treatment without telling your provider and the insurer
- Signing a full and final release without independent advice
VIA Legal represents injured people in accident benefits disputes before the LAT, on a contingency basis. We review your denial letter for free and tell you whether a dispute makes sense in your situation. Nothing to pay unless we win, and we serve clients in English, Russian, Ukrainian and Armenian.
Frequently asked questions
Can I go to court instead of the LAT?
Accident benefits disputes in Ontario go to the LAT. A separate claim against the at-fault driver is a different process.
The insurer stopped my income replacement after an examination. Can I challenge it?
Yes. Medical evidence from your own providers is central to that kind of dispute.
How long does a LAT dispute take?
It depends on the issues and the tribunal's schedule. Some disputes resolve at the case conference; others go to a hearing.
VIA Legal Services Professional Corporation. Naira Velumyan is a Licensed Paralegal in Ontario (LSO #P21370). This article is general information, not legal advice for your specific situation.
Naira Velumyan is a Licensed Paralegal in Ontario and the principal of VIA Legal. She holds a PhD in psychology and is a Registered Psychotherapist, which shapes how she handles psychological injury claims. Read more about Naira