Allstate has beaten a claimant's bid to escape Ontario's Minor Injury Guideline (MIG) after a tribunal rejected an attempt to shift the burden of proof.

The claimant was hurt in a car accident on March 26, 2024, and applied for accident benefits, including funding for a psychological assessment. Allstate found his injuries - the kind of sprains, strains and whiplash the guideline is built around - were predominantly minor, holding him to the MIG's $3,500 cap on medical and rehabilitation coverage. He took the dispute to Ontario's Licence Appeal Tribunal and challenged the denial of a $2,200 psychological assessment set out in a treatment plan dated June 27, 2024.

Rather than arguing the medical evidence put his injuries outside the MIG, the claimant tried a different tack. He argued he only needed to show that Allstate's written denial, issued July 5, 2024, was frivolous, flawed, arbitrary or otherwise deficient - not that his injuries actually warranted removal from the cap.

Adjudicator Melanie Malach shut that down. She pointed out the same argument has come up again and again before the Tribunal, and lost every time, citing five earlier rulings - including one against Allstate itself - where the identical position failed. A denial notice, she explained, only needs to lay out an insurer's reasons clearly enough for a claimant to decide whether to dispute it. It doesn't lock the insurer into those reasons at a hearing, and it doesn't let a claimant skip the job of proving their own case.

On the medical side, the claimant's evidence didn't hold up. His only support for leaving the MIG was a psychological pre-screen report attached to the treatment plan, listing symptoms including specific phobias, headaches, nightmares, sleep problems, irritability and anger - all based entirely on his own self-reported symptoms, with no clinical records, no diagnostic testing and no formal diagnosis behind them. Malach found that wasn't enough to show, on the available evidence, a psychological impairment serious enough to lift the cap.

Malach also found Allstate's denial notice gave the claimant enough detail to satisfy the rules. It named the treatment plan, explained that his injuries remained within the MIG, flagged the missing clinical evidence, and pointed him to $400 in psychosocial funding still available under the cap.

With the claimant staying inside the MIG, Malach dismissed the application entirely, along with his claims for interest and a special award for withheld benefits. The ruling was released September 9, 2026.