No Opting Back Into Ontario SABS

When an automobile accident occurs outside of Ontario, in particular, in another province or territory of Canada, or in the United States, a claimant may elect to receive either Ontario-level benefits or benefits under the law of the jurisdiction where the accident occurred as if the person was a resident of that jurisdiction.

In J.W. v. Wawanesa Insurance, 2019 ONLAT 18-003407/AABS, the claimant was a resident of Ontario who was seriously injured in an automobile accident in Quebec. She elected to receive benefits under the Quebec no-fault accident benefits scheme.

Over the years, the fee for service guidelines in Ontario and Quebec have changed, resulting in the hourly rates in Ontario for service providers being higher than the hourly rates in Quebec.

The claimant sought to continue receiving benefits under the Quebec scheme, but to have these benefits paid at the Ontario hourly rate.

The claimant argued that the amount paid to service providers is a procedural matter and that procedural matters are to be governed by the jurisdiction where the claim is administered (in this case, Ontario).

Vice-Chair Flude disagreed with the claimant’s arguments, indicating that the legislation is clear. Once the claimant elected to receive Quebec–level benefits, she was bound to the Quebec scheme with no option to opt back into all or part of the Ontario scheme.