Ontario's Licence Appeal Tribunal has dismissed a reconsideration bid challenging whether insurers can rely on examination reports tied to allegedly deficient notices.
The decision in Goodarzi v. Allstate Insurance Company of Canada, 2026 CanLII 48413 (ON LAT), released May 15, 2026, by adjudicator Ulana Pahuta, sided with Allstate on a question that has split recent Tribunal panels: what happens when an insurer's section 44(5) notice for an insurer's examination is not fully compliant with the Statutory Accident Benefits Schedule.
Goodarzi asked the Tribunal to vary an earlier decision dated February 18, 2026, which found she was not entitled to income replacement benefits, interest or an award, and ordered her to repay Allstate $442.10. She filed the reconsideration request on March 11, 2026, under Rule 18.2(b) of the Licence Appeal Tribunal Rules, 2023.
Her central argument was that the insurer's examination reports Allstate used to deny her ongoing income replacement benefits were void ab initio because the underlying section 44(5) notices were non-compliant. Without valid reports, she said, the insurer had no medical basis to deny benefits. She leaned on the Court of Appeal's reasoning in Tomec v. Economical Mutual Insurance Company, 2019 ONCA 882, arguing the Schedule's consumer protection purpose required treating improperly obtained examinations as unusable.
The Tribunal did not agree. The adjudicator found the original decision was not irreconcilable with Tomec. While Tomec confirmed the Schedule is remedial, consumer protection legislation, applying the principle of discoverability to a limitation period was a different exercise from reading in a significant consequence not contained in the Schedule.
The Tribunal also pointed to a key fact: Goodarzi attended the examinations. Because she attended, section 55(1) did not apply. The adjudicator wrote that even if the notice had been deficient, the resulting reports would still be considered, "although the lack of a compliant notice might go to weight."
Goodarzi also pointed to Bisnauth v. Jevco Insurance, 2025 CanLII 129060, where the Tribunal had not accepted that insurers could rely on improperly requested examinations. Allstate countered with Malone v. RSA Insurance, 2025 CanLII 518, which held that the built-in consequence for inadequate notice is simply that the insured does not have to attend - nothing more.
The adjudicator noted that while both decisions were instructive, neither is binding. She found the applicant was effectively trying to re-litigate arguments already addressed at the initial hearing, which is not a proper use of the reconsideration process.
For insurers and claims handlers, the takeaway is in the reasoning: the Tribunal declined to read a new consequence into the Schedule. Where an insured attends an examination, even a notice that may fall short of section 44(5) does not automatically prevent the insurer from relying on the resulting report.
The reconsideration request was dismissed.
