An Ontario tribunal has reminded claimants that skipping an insurer's medical examination can sink a benefits claim before it ever reaches a hearing.
In Dhillon v Belair Insurance Company Inc., 2026 CanLII 53774 (ON LAT), the Licence Appeal Tribunal dismissed an accident victim's bid for statutory accident benefits after she failed to attend two insurer's examinations and could not prove psychological injuries that fell outside Ontario's minor injury cap.
Parwinder Dhillon was involved in an automobile accident on December 11, 2022, and sought benefits under the Statutory Accident Benefits Schedule. Belair Insurance Company Inc. denied the claims, and Dhillon applied to the Tribunal to resolve the dispute.
A central problem for Dhillon was attendance. Belair scheduled an insurer's examination with a general practitioner physician to assess whether her injuries fell within the Minor Injury Guideline and whether her claimed physiotherapy was reasonable and necessary. She missed the original June 10, 2024 date and a rescheduled July 24, 2024 date, offered no explanation, and never confirmed she would attend a future date.
Under section 44 of the Schedule, an insurer may require an insured person to attend an examination that is reasonably necessary. Section 55(1) bars a claimant from proceeding to a hearing if they fail to attend a properly scheduled examination, though section 55(2) gives the Tribunal discretion to let a non-compliant applicant continue.
Adjudicator Teresa Walsh found that Belair's June 27, 2024 and July 29, 2024 letters satisfied the notice requirements of section 44(5), and that the examination was reasonably necessary. Because Dhillon gave no reasonable explanation and did not help reschedule, Walsh declined to exercise that discretion. Dhillon was barred from pursuing her $2,490.58 physiotherapy claim.
The psychological claims fared no better. Dhillon relied on a July 13, 2023 report from psychotherapist Nicole Presutti, prepared under the supervision of psychologist Dr. Jacqueline Brunshaw, which found her presentation consistent with features of post-traumatic stress disorder, adjustment disorder with anxiety, major depressive disorder, and a vehicular-related phobia.
Walsh gave that report limited weight. It appeared to rest on the applicant's self-reporting during a single interview, did not account for her family physicians' treating records, and contained inconsistencies. Those records showed pre-accident medication, including a prescription for depression, and her family physicians routinely noted that she appeared well at appointments.
Belair's own examination report, from neuropsychologist Dr. Mohammad Nikkhou, found the applicant's psychological test results either invalid or uninterpretable and identified no formal diagnosis attributable to the accident. Walsh found Dhillon had not proven an accident-related psychological impairment warranting treatment outside the Minor Injury Guideline, where benefits are limited to $3,500.
Dhillon also sought an award under section 10 of Regulation 664 for unreasonably withheld benefits. The Tribunal noted that an insurer's conduct must be "excessive, imprudent, stubborn, inflexible, unyielding or immoderate" to justify such an award. Finding no payments were unreasonably withheld, Walsh denied it.
The application was dismissed and no interest was payable. The decision was released May 29, 2026.
