An Ontario tribunal has upheld CAA Insurance Company‘s denial of an accident benefits claim after ruling that the young claimant failed to provide a reasonable explanation for filing his application nearly a year late.
The case stems from a single-vehicle crash on June 15, 2024, in which the claimant, then 17, was a passenger in a vehicle driven by a relative. The driver reported the crash to CAA on June 25, 2024. CAA contacted the claimant by phone two days later and mailed him an accident benefits package the following day.
Under Ontario’s accident benefits rules, claimants are required to submit their application, known as an OCF-1, within 30 days of receiving that package. In this case, the claimant did not file until June 19, 2025, roughly a year after the accident. CAA denied the claim on January 16, 2026, stating that his explanation for the delay was not reasonable, prompting the dispute to move to the Licence Appeal Tribunal.
Tribunal Rejects Claimant’s Explanations
During an examination under oath, the claimant said he did not own a cellphone at the time of the crash and that a caseworker he met with monthly never assisted him with the paperwork. CAA disputed this, pointing out that it had successfully reached him by phone at a number he had confirmed as his best point of contact.
The insurer requested access to his cellphone records and his file with the child welfare agency overseeing him at the time, in order to verify his claims. The claimant refused, arguing the records were not relevant to the timing dispute.
Adjudicator Melanie Malach disagreed, ruling that the withheld records were central to assessing the credibility of his evidence and that his refusal to provide them worked against his case. She also noted that during the period in question, the claimant was managing a bank account, a summer job, and his own apartment, which she said undermined the argument that his age alone explained the delay.
Limitations Act Argument and Credibility Concerns
The claimant also argued that Ontario’s Limitations Act should extend his filing deadline to his 18th birthday. Malach found that even accounting for that extension, his application was still submitted five months late.
CAA further argued that the delay compromised its ability to investigate the claim while evidence was still fresh, and pointed to inconsistencies in the claimant’s account of a hospital visit as an additional credibility issue. Malach agreed that these factors compounded the harm CAA experienced as a result of the late filing.
Ultimately, Malach concluded that the claimant had not established a reasonable explanation for the delay. She barred him from pursuing the claim and dismissed the application, cancelling hearing dates that had been scheduled for November 2026.
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