A claimant who lost her Minor Injury Guideline fight in 2021 cannot relitigate it through new treatment plans, Ontario's Licence Appeal Tribunal ruled.
The decision, released June 23, 2026, dismissed the claim at a preliminary stage on the doctrine of res judicata, handing Co-operators General Insurance Company a full win.
The claimant was hurt in an automobile accident on February 3, 2016, and sought benefits under the Statutory Accident Benefits Schedule. Co-operators denied them, and the dispute first reached the Tribunal in 2021. A decision dated May 25, 2021, placed her injuries within the Minor Injury Guideline, capping medical and rehabilitation funding at $3,500.00. The insurer had been named Coseco in that earlier matter; the Tribunal confirmed Coseco and Co-operators are one and the same following a merger.
On February 10, 2025, the claimant filed again. This time she disputed a stack of treatment and assessment plans, including $3,097.48 for physiotherapy, several medical assessments at $2,486.00 apiece, and a $25,379.50 plan for catastrophic impairment assessments. Co-operators argued the MIG question had already been decided and could not be reopened.
Adjudicator Nadia Mauro agreed. Applying the Supreme Court of Canada's test in Danyluk v. Ainsworth Technologies Inc., she found all three preconditions for issue estoppel met: the same question had been decided, the earlier decision was final, and the parties were identical. The claimant, she found, was "attempting to relitigate an issue that was previously determined by this Tribunal."
The claimant's central argument was that a MIG determination attaches only to the specific plans a tribunal considers, not to the injuries globally - meaning each newly denied plan should open a fresh MIG hearing. She leaned on earlier authority, including the Divisional Court decision in Zheng, to argue that an insurer's non-compliant denial could not lock in the MIG.
Mauro rejected that reading. Zheng, she found, prevents an insurer only from using the $3,500.00 MIG limit to sidestep paying for a plan it improperly denied; it does not permanently remove a claimant from the MIG or convert every denial into a new hearing. Once the injury-category threshold is decided, the finding holds absent fresh, new evidence that would conclusively impeach the original result.
The claimant offered clinical records, but Mauro found they were self-reported, pre-dated the first hearing, or were unsigned and of unclear authorship - none of it enough to reopen the file.
The Tribunal also addressed the insurer's denial notices. Mauro found Co-operators' letters complied with section 38(8) of the Schedule, so the plans were not payable under section 38(11). Pointing a claimant to a prior MIG ruling, she held, counts as a medical reason, because a minor-injury finding is itself a medical definition under the Schedule.
With no benefits owing, there was no interest and no special award under section 10 of Regulation 664, which can reach 50 per cent of benefits payable where an insurer unreasonably withholds or delays payment. The application was dismissed.
