Definity Insurance Company has come away with a clean win at Ontario's Licence Appeal Tribunal, in a decision released on May 6, 2026 that offers Canadian auto insurers a useful template for defending against late-developing injury claims.
The case, Csucs v. Definity Insurance Company, turned on what happened - and what didn't happen - in the hours and months after a December 10, 2021 car accident. The applicant, Leslie Csucs, walked into Bluewater Health that day with a bump and bruise on her forehead, a headache, and back pain stretching down to her tailbone. Staff did not order a CT scan, did not refer her to a concussion clinic, and discharged her with a diagnosis that included a minor head injury. She was alert, talking clearly, and walking on her own.
Nearly two years later, the story changed. In July 2023, a chiropractor recorded a concussion. In April 2024, a physiatrist, Dr. Keith Sequeira, diagnosed both a concussion and chronic pain syndrome. On that evidence, Csucs argued she belonged outside the Minor Injury Guideline - the $3,500 cap that limits medical and rehab benefits for sprains, strains, whiplash, and similar soft-tissue injuries - and was entitled to income replacement, attendant care, and additional treatment plans.
Adjudicator Harouna Saley Sidibé wasn't persuaded. The early hospital records, he wrote, were "contemporaneous, treatment-focused, and consistent with the early accident documentation." The later reports, by contrast, leaned "heavily on the applicant's self-reported history rather than contemporaneous clinical findings." The chiropractor's concussion notation got short shrift for a simple reason: "As a chiropractor, Dr. Simpson is not qualified to diagnose a concussion."
The insurer's section 44 examiner, Dr. Pankaj Bansal, who assessed Csucs in September 2023 and issued an addendum in June 2024, concluded that her injuries were uncomplicated soft-tissue injuries that had been self-resolving. The Tribunal preferred his analysis, noting it lined up with the emergency records and the early accident benefit forms, neither of which mentioned a concussion.
The income replacement claim fared no better. Csucs had worked part-time at her family's taxi business, handling office tasks and some driving. Employer records showed flexible hours, work-from-home invoicing, and no pay loss tied to the crash. Her job ended, the Tribunal found, because she stopped showing up and couldn't be reached - not because the accident had left her unable to do the work. The adjudicator also noted that she took on delivery work with Instacart in 2023, calling that activity "inconsistent with the level of incapacity alleged."
The post-104-week IRB question was dispatched quickly. Citing the Ontario Superior Court's recent ruling in Paesano v. Co-operators Insurance Company, the adjudicator confirmed that you can't qualify for the longer-term benefit without first qualifying for the shorter one. The attendant care claim of $1,261.76 per month, the treatment plans, and the interest claim all fell with it. The application was dismissed.
For Canadian auto insurers, the takeaway is straightforward: the early paper trail often does the heavy lifting.
