Executive Summary: Key Legal and Evidentiary Issues

• Appeal focused on denial of income replacement and medical benefits under the Statutory Accident Benefits Schedule (SABS).

• The LAT ruled the benefits were not payable due to insufficient evidence of entitlement.

• A reconsideration request was dismissed due to late filing and lack of jurisdiction.

• Divisional Court found it had no jurisdiction over interlocutory decisions by the LAT.

• Allegations of procedural unfairness were rejected due to adequate written process and reasoning.

• Appellant’s challenge to the LAT’s factual findings did not raise valid questions of law for appeal.

Facts and procedural background

Brenda Jendrika was involved in a motor vehicle accident on December 4, 2016. Following the accident, she applied to Intact Insurance Company for various benefits under the Statutory Accident Benefits Schedule (SABS), including income replacement benefits (IRBs), medical and rehabilitation expenses, and an award for interest. Intact denied these claims, prompting Jendrika to appeal to the Licence Appeal Tribunal (LAT).

On May 20, 2022, the LAT denied her entitlement to IRBs for both the initial 104-week period following the accident and any period thereafter. It also rejected her medical and rehabilitation claims, concluding that the proposed treatments were neither reasonable nor necessary. Additionally, it found no basis for ordering interest or an award, as there were no benefits unreasonably withheld or delayed.

Reconsideration efforts and procedural complications

Jendrika attempted to file a reconsideration request after the deadline set by Rule 18.1 of the LAT’s Common Rules of Practice and Procedure. The LAT denied her motion for a time extension, applying its established four-factor test. A subsequent request to reconsider that denial was also dismissed on the ground that LAT decisions that do not finally dispose of an appeal—such as those dealing with extensions of time—are interlocutory and not subject to reconsideration.

The matter proceeded to the Divisional Court. Initially, Jendrika appealed only the LAT’s denial of her reconsideration request. At a case conference, the scope of the appeal was expanded to include the underlying substantive decision. After a health-related adjournment, the court directed that the appeal proceed in writing. Jendrika requested further time to file submissions, citing ongoing medical issues, but her requests were ultimately denied after repeated extensions. She failed to provide additional submissions by the court-imposed deadline of January 10, 2025.

Issues on appeal and court findings

The court considered three main issues: its jurisdiction to review the LAT’s interlocutory decisions, whether the LAT denied procedural fairness, and whether there were errors of law in the LAT’s substantive findings.

First, the Divisional Court concluded it lacked jurisdiction to hear appeals from interlocutory decisions, including the LAT’s denial of the time extension and the reconsideration thereof. These decisions were procedural and did not finally resolve the matter.

Second, the court rejected Jendrika’s claim that the LAT failed to provide procedural fairness by deciding the case in writing rather than through an oral hearing. The LAT had discretion to proceed in writing, and the adjudicator had fully engaged with the evidence and explained her reasoning.

Finally, the court found that Jendrika’s arguments regarding errors in the LAT’s decision involved questions of fact or mixed fact and law, rather than pure questions of law. The adjudicator applied the correct legal test for entitlement to IRBs both before and after the 104-week mark and provided sufficient reasoning for preferring the insurer’s medical evidence. The court emphasized that disagreements over evidence assessment do not amount to errors of law.

Conclusion and outcome

The Divisional Court dismissed Jendrika’s appeal in its entirety. It confirmed that the LAT acted within its jurisdiction and adhered to proper legal standards. As a result, Jendrika remained ineligible for the benefits she sought. Costs were awarded against her in the amount of $5,000, payable to Intact Insurance Company within 30 days.