Aviva has beaten a bid for a special award at Ontario's accident benefits tribunal, which ruled a 90-day delay was not unreasonable.
In Rementizo v Aviva Insurance Company of Canada, 2026 CanLII 56653 (ON LAT), Vice-Chair Robert Maich declined to penalize the insurer over how it handled a claimant's treatment plans, a result that turned on Aviva's reliance on examiner opinions and its adjusting of the file.
Norianne Rementizo was injured in an automobile accident on November 26, 2023, and sought statutory accident benefits. Aviva denied the claims, and she applied to the Licence Appeal Tribunal. By the time of the written hearing, she had been removed from the Minor Injury Guideline and Aviva had approved $2,150.24 for chiropractic services and $2,200.00 for a psychological assessment. The only questions left were whether the insurer owed a special award under section 10 of Regulation 664 and interest on the overdue benefits.
Section 10 lets the Tribunal order up to 50% of withheld amounts where an insurer's conduct is found to be "excessive, imprudent, stubborn, inflexible, unyielding, or immoderate."
Aviva's denials rested on insurer's examinations. On October 16, 2024, Dr. Belfon concluded the applicant had sustained an uncomplicated cervical spine sprain/strain and headaches that had resolved, requiring no further treatment. On October 29, 2024, psychologist Dr. Saghatoleslami found she did not meet DSM-5 criteria for any mental health disorder and opined a psychological assessment was not reasonable or necessary. The insurer denied both treatment plans in November 2024 and maintained the denials after a December 6, 2024 addendum.
Rementizo argued the psychological assessment was flawed - built on a single session and, in her submission, a defensive, litigation-oriented addendum that disregarded her family physician's records of nightmares, night terrors and psychological distress. She said those records, provided to Aviva on June 6, 2025, were not acted on until September 16, 2025, when the insurer agreed to pay both plans - a delay she called unjustified.
Maich was not persuaded. He found nothing unusual in an insurer ordering examinations before paying a benefit, noting the Schedule anticipates that step. An insurer is entitled to rely on the opinions of its section 44 assessors, he wrote, and should not be held to a standard of perfection. As the file developed, Aviva commissioned further reports and an addendum, which he treated as a mitigating factor showing it had turned its mind to the file.
The roughly 90-day span the applicant complained about did not change the result. Maich found limited evidence that the timeline was excessive given the insurer's ultimate decision to remove her from the MIG, adding that 90 days was not unreasonable to process and balance information for a major decision. He also gave weight, on public policy grounds, to the insurer's voluntary action benefiting the insured.
The Tribunal found no award was warranted but held that interest applies on the overdue benefits in dispute under section 51 of the Schedule. The decision was released June 11, 2026.
