TD General Insurance sought over $4,300 in overpaid accident benefits from a claimant - but a missed deadline cut the recovery by more than half.
In a decision released on April 23, 2026, Ontario's Licence Appeal Tribunal found that TD could recover only $1,697.09 of the $4,336.81 it had claimed from Nikhil Aggarwal, who had been collecting income replacement benefits after a January 20, 2023 automobile accident. The issue was not whether the money was owed. It was whether TD asked for it back in time.
After the accident, TD began paying Aggarwal $213.39 per week in income replacement benefits. In September 2023, Aggarwal told TD he had gone back to part-time work. TD then reached out to his employer, RONA, and learned he had actually returned to full-time work on September 25, 2023. A surveillance report by Xpera Investigations later depicted Aggarwal working as a sales associate at Leons Furniture Super Store in October 2024.
Armed with paystubs it received in January and March 2024, TD sent two repayment notices - on February 10, 2024 and March 12, 2024 - requesting a combined $1,697.09 for the period from August 19 to December 31, 2023. Those notices checked every requirement under section 52 of the Statutory Accident Benefits Schedule: they identified the overpayment, specified the period and amount, and arrived within the 12-month window the regulation demands.
But TD did not stop there. On October 24, 2024, it issued a new notice recalculating the overpayment at $4,336.81, stretching the claim back to January 28, 2023. TD then filed its application with the Tribunal on November 1, 2024, seeking the full amount.
That is where things came apart. Adjudicator Lisa Holland found the October 2024 notice landed more than 12 months after the payments TD was trying to claw back. Under section 52(3) of the Schedule, an insurer must notify a claimant of an overpayment within 12 months of making it - unless the overpayment was caused by fraud or wilful misrepresentation. TD had the paystub information since early 2024 and offered no explanation for waiting until late October to act. The Tribunal found no evidence of fraud.
The result: TD recovered $1,697.09, plus interest, based on its earlier, compliant notices. Aggarwal's request for costs was denied, with the Tribunal noting it could not characterize TD's conduct as unreasonable, frivolous, vexatious, or in bad faith.For insurers handling accident benefit claims in Ontario, the takeaway is straightforward. The 12-month notice rule under section 52 is not flexible. New information does not restart the clock. And delays in acting on what an insurer already knows can permanently shrink what it is entitled to recover.
