An insurer dodged a special award after reversing its catastrophic-impairment denial, but a tribunal still ordered costs for misrepresenting its own file.
In Singh v Aviva General Insurance Company, 2026 CanLII 56644 (ON LAT), Vice-Chair Brian Norris denied Arjan Singh's request for an award under section 10 of Regulation 664, while ordering Aviva to pay $500 in costs. The decision was released June 8, 2026.
Singh was injured in an automobile accident on July 1, 2015, and sought statutory accident benefits from Aviva. The insurer denied his catastrophic impairment application, obtained insurer's examinations, and concluded he was not catastrophically impaired. Singh applied to the Licence Appeal Tribunal. At the case conference, Aviva reversed course and agreed he had sustained a catastrophic impairment.
Singh then pursued a section 10 award, which lets the tribunal grant up to 50 per cent of total benefits payable when an insurer unreasonably withholds or delays payment. To succeed, he had to show Aviva acted in a manner that was excessive, imprudent, stubborn, inflexible, unyielding, or immoderate.
Norris found Singh did not meet that onus. Disagreeing with assessment reports was not stubbornness, relying on the insurer's examinations was not imprudent, and good faith reliance on expert opinion was not the kind of conduct an award is designed to repudiate. The Schedule allows insurers to seek their own assessments when responding to a catastrophic impairment application, and Aviva initially agreed with its assessors.
The decision also clarified a point relevant to claims handling. Norris found the Schedule does not require an insurer to provide medical and other reasons when it approves a benefit or designation. Section 45(3)(a) imposes no such obligation for approving a catastrophic impairment application; medical and other reasons are required under section 45(3)(b) only when the insurer determines the impairment is not catastrophic.
The timing of the reversal did not change the result. The delay was approximately five months, which Norris distinguished from Driscoll v. Allstate, where the delay reached nearly two years, and from Larmond v. Onlia, where the insurer delayed relaying its reversal. He also noted Singh had access to medical, rehabilitation, and attendant care funding without the catastrophic designation, so there was virtually no monetary reason he could not obtain reasonable and necessary goods and services.
Aviva did not escape entirely. Norris ordered it to pay $500 in costs because, through its employee and legal representative, it had misrepresented at the case conference that the log notes would show the basis for the approval. The adjuster confirmed in testimony that the log notes contained no such reasons.
While the insurer was not required to give reasons for the reversal, Norris wrote, it could not misrepresent that those reasons were in the log notes. He called the misrepresentation serious conduct that interfered with the tribunal's ability to carry out a fair, efficient and effective process.
Norris also cautioned Singh's counsel over the tone of their written submissions but declined to order costs against the applicant. No interest was payable.
