Legislature didn’t intend tribunal and court to determine same questions, grant different relief

Insurance - Actions on Policies - Practice and Procedure

Insured was injured in car accident. Insured alleged that insurer was liable to pay Statutory Accident Benefits and had showed bad faith, negligence, and fraud. Insurer submitted that legislation prevented insured from pursuing claim but did not bar independent claim for bad faith in administration of accident benefits. Insurer successfully moved to strike statement of claim on ground that it disclosed no reasonable cause of action. Caselaw dictated that Insurance Act applied if refusal of accident benefits was essential part of claim Act applied whether or not bad faith in administering claim existed as independent tort in context of accident benefit. License Appeal Tribunal (Tribunal) had exclusive jurisdiction to decide claim at first instance. Insured appealed. Appeal dismissed. At their core, facts alleged in insured’s statement of claim were about insurer's failure to provide benefits to which insured was entitled. To determine bad faith claim, court would have to determine benefits to which insured was entitled, their amount and when they ought to have been provided, matters which fall within tribunal's jurisdiction. Legislature did not intend both tribunal and court to determine same questions on path to granting different relief. Tribunal had jurisdiction to grant relief for insured's claim.

Stegenga v. Economical Mutual Insurance Company (2019), 2019 CarswellOnt 11602, 2019 ONCA 615, David Brown J.A., L.B. Roberts J.A., and B. Zarnett J.A. (Ont. C.A.); affirmed (2018), 2018 CarswellOnt 3336, 2018 ONSC 1512, J.A. Ramsay J. (Ont. S.C.J.).

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