Aarooj v. TD General Insurance Company, 2024 ONLAT 21-014314/AABS

• Started business in year of MVA
• IRB is $nil as earned no income in the last taxation year

FT and Co-Operators LAT (19-001291/AABS) Link Here

• 52-weeks only option for self-employed individuals when there is no last taxation year (Business started in year of the accident)
• IRB based on income from the two businesses in the 52-weeks.

Eid v. Allstate LAT 20-001143/AABS

• Maternity leave in last tax year
• Adjudicator says yes it infringes on her human rights but calculation is still based on last tax as she is self employed
• 52-weeks disallowed.

Maria Fatima Oliveira and Aviva (LAT 21-00854/AABS)

• Partnership with spouse (50-50) cleaning business (unincorporated)
• Must use last tax year as self-employed

Kfouri v. TD LAT 19-006916/AABS

• Self-employed for husband's limo business
• Based on last tax as reported to CRA

Not all "CERB" is the same. Some benefits were paid as Employment Insurance Emergency Response Benefits. These benefits were paid under the Employment Insurance Act, and as such, would appear to meet the definition of 'gross employment income' pursuant to s.4(1) of the SABS. We are not aware of any decisions which address this key distinguishing factor.  

TD General Insurance Company v. Clarke, 2024 ONLAT 22-010547/AABS

• CERB, CRB, CRCB are not income for IRB purposes.
• Although mentions none of the ‘suite of benefits’ due to covid meet definition of gross employment income, it does not address the COVID-19 benefits received under the Employment Insurance Act. 
• Repayment of IRBs not granted to the insurer as the reason for overpayment was them continuing to pay when in non compliance due to a s. 33 request. Indicates the insurer should have stopped the payments, not later sought repayment.

Matende v. CAA Insurance Company, 2024 ONLAT 23-002630/AABS

• IRB eligibility ended when applied for CERB as the application indicates insured was ready, willing and able to work at that time

Karla Coto and Intact - Reconsideration 2023 CanLII 116474

• CERB is not income for IRB purposes.

It is important to know that some IRB overpayments can be hidden in updated IRB calculations, reducing the outstanding IRB payable but never be identified as overpayments. This can lead to IRBs being recovered which were paid more than 12-months ago, and as such, no longer recoverable pursuant to s.52(3) of the SABS (assuming no willful misrepresentation). 

Akhuanzada v. Aviva Insurance Company of Canada, 2025 ONLAT 24-002749/AABS

• Notice of overpayment invalid as doesn’t indicate what period it relates to.

Security National Insurance Company v. Bingham, 2025 ONLAT 23-007576/AABS

• First overpayment notice was within the 12 months but insurer later changed the amount and concluded there was no overpayment for that period
• They later decided to request repayment. The second notice was more than 12 months from last day benefits were paid
• Not recoverable as new notice more than 12 months since IRBs in question paid. 
• In summation, you cannot rely on the date of a first notice if that notice is wrong or later revoked.

TD General Insurance Company v. Chandran, 2025 ONLAT 23-003971/AABS

2025 CanLII 18220 (ON LAT) | TD General Insurance Company v Chandran | CanLII

• Failed to inform the insurer of a return to work.
• Overpayment fully recoverable as deemed caused by misrepresentation
• Includes the LAT's definition of willful misrepresentation

Betteley v. Certas Home and Auto, 2024 ONLAT 22-003958/AABS

• Overpayment due to retro-active CPPD:
• Notices invalid if issued before the retroactive CPPD payment is actually received by the applicant. 
• And notice has to be limited to 12 months.

Arunasalam v Pembridge Insurance Company, 2023 ONLAT 21-000269/AABS

• Insured returned to work Oct 9, 2018 but failed to inform the insurer, and as such, IRBs continued to be paid
• Initial request for repayment was made Jan 14, 2019, asking for income documentation and repayment of $6,400. The letter said “should an overpayment been made..it will request payment” but then also asks for payment by Feb 1, 2019 or interest will begin.
• This decision concludes that making an equivocal request for repayment (should there be an overpayment….) is not a valid notice.

Without a definition of the term 'employed' in the SABS, it was long thought that having an employment relationship was sufficient to be considered employed for IRB purposes. The below decisions confirm that is not the case, the insured must be providing services in exchange for compensation.

Abazi v Unifund Assurance Company, 2026 CanLII 4132 (ON LAT)

• Stopped working March 2020 due to the pandemic
• MVA was in October 2020
• Employment officially terminated in 2022
• Decision: Not 'employed' at the MVA
• Employment relationship or intent to work does not equate to being 'employed'

Naddafi v The Personal Insurance Company, 2026 CanLII 2248 (ON LAT)

• On LTD at the MVA and for the last 20 years
• Being on LTD does not equate to being 'employed' for IRB purposes. 

O'Boyle v Co-operators General Insurance Company, 2023 CanLII 72649 (ON LAT)

• MVA Jun 30, 2020. Insured stopped working the prior September, received EI until December and banked hours until resigning in February 2020. 
• Issue at hand: Does the period during which she was technically employed and receiving money for banked hours count as being employed for IRBs
• Decision: No, not eligible
• References the Arab divisional court decision (included below) and says bound by that. 
• 'Employed' is connected to income -earning and receiving wages for services being rendered. As such, need to be providing services for at least 26 of the last 52 weeks

Nouracham v. Aviva (LAT 21-000224/AABS) 

• Insured worked ‘on call’ at a pasta factory
• Worked 9 weeks in a 17 week period prior to MVA 
• Insured argued they were eligible for IRBs as they were employed even though not actively working at time of MVA
• Decision: Existence of an employment relationship does not satisfy s.5(1)(1)(i)
• This decision was confirmed at Divisional Court – Link here
  

Divisional Court: 

Kawa Arab v. Unica Insurance, 2022 ONSC 5761

• MVA Sept 16, 2016
• Insured absent from work since Feb 11, 2016 (last paid Feb 13/16)
• Formally terminated Nov 30/16 (1.5 months after MVA)
• Received EI until Jun 12/16
• As such, worked 20 of 52-weeks and EI stopped pre
• Decision: There was still an employment relationship at time of MVA, however, that does not mean 'employed' for IRB purposes

Devi v Allstate Canada, 2022 CanLII 65662 (ON LAT)

• Insured was employed for 180 days or 25.71 weeks.
• Insured argued that is the same as 26 work weeks
• Decision – not eligible for IRBs. Need to be working for the full 182 days.