Aviva kept a rear-end collision claimant inside Ontario's $3,500 minor injury cap after an insurer's examiner flagged possible exaggeration and failed validity testing. The Licence Appeal Tribunal released Rowe v Aviva General Insurance Company, 2026 CanLII 56660 (ON LAT) on June 8, 2026, dismissing Raphel Rowe's bid to escape the Minor Injury Guideline after a 2023 collision. For claims professionals, the decision is a clean illustration of how insurer's examination findings and disciplined evidence rules can hold a soft-tissue file within the cap.
Rowe was struck from behind on August 11, 2023. First responders attended, and the damage left him unable to drive away, but he sustained no cuts or scrapes and declined to go to hospital. He later reported anxiety, sleep disturbances and ongoing pain to his lower back, neck, shoulders and forehead.
Aviva classified the injuries as minor and held treatment to the $3,500 MIG limit. Rowe argued that psychological impairment and chronic pain warranted removal, and sought funding for two treatment plans denied on March 1, 2024 - a $2,200 psychological assessment and $2,024.02 in chiropractic, physiotherapy and massage therapy. The parties agreed Aviva had already paid $3,395.62 in medical and rehabilitation benefits.
The psychological claim collapsed on the insurer's examination. Psychologist Dr. Douglas Saunders, in a July 4, 2024 report, found Rowe's behaviour and demeanour inconsistent with his reported symptoms, flagged response patterns suggesting defensiveness and possible exaggeration, and concluded he failed validity testing and had no psychological impairment. Adjudicator Bernard Trottier also noted that Rowe continued working as a ride share driver 35 to 40 hours per week, as he had before the crash - undercutting his claim of driving anxiety.
Trottier gave little weight to a pre-screening interview recorded on the treatment plan itself, reiterating the Tribunal's position that an OCF-18 is generally not medical evidence. Some form of contemporaneous corroboration was required, and Rowe's records offered only a single mention of anxiety and poor sleep across roughly 21 months.
The chronic pain argument fared no better. A general practitioner who conducted an insurer's examination on May 30, 2024 observed Rowe sitting comfortably and moving fluidly with no visible distress, and diagnosed sprain and strain injuries plus a soft tissue head injury - all minor. Rowe pointed to his family physician's handwritten clinical notes, but the Tribunal found them largely illegible and excluded a late-disclosed batch entirely. Trottier stressed that "a party cannot point to large blocks of evidence" and expect the adjudicator to build the case for them.
With no corroborated psychological impairment and no evidence of chronic pain or functional impairment, Trottier kept Rowe within the MIG. The disputed treatment plans were not payable, and no interest was owed. Because the cap was not exhausted, Rowe may still pursue treatment within the MIG, provided it is reasonable and necessary.
