Intact Insurance has defeated a claimant's bid to escape Ontario's minor injury cap after a tribunal found her pain complaints unsupported by her own medical records.
That was the outcome in Ibrahim v Intact Insurance Company, 2026 CanLII 56648 (ON LAT), a decision released June 9, 2026 by the Ontario Licence Appeal Tribunal. The ruling keeps Hawa Ibrahim's treatment within the $3,500 Minor Injury Guideline limit and denies every benefit she sought.
Ibrahim was injured in an automobile accident on December 2, 2024, and applied for statutory accident benefits. Intact denied the benefits, and she brought the dispute to the Tribunal. She asked to be removed from the Minor Injury Guideline, or MIG, arguing that pre-existing migraine headaches and other health issues stood in the way of her recovery. She also claimed a non-earner benefit of $185.00 per week and $2,721.09 for a physiotherapy treatment plan.
Adjudicator Timothy Porter rejected each claim.
On the MIG question, the analysis turned on what the medical records actually showed. Section 18(1) of the Schedule caps medical and rehabilitation benefits at $3,500.00 where an insured's impairments are predominantly minor. A claimant can be removed from the MIG with a documented pre-existing condition plus compelling evidence that the condition precludes recovery inside the guideline. Ibrahim relied on her testimony, her family physician's records, and physiotherapy care notes.
The records did not carry her case. After her accident, Ibrahim was diagnosed with sprains and strains at St. Joseph's Health Care Hamilton, and imaging showed no fractures. Her physiotherapy intake recorded a sprain and strain of the cervical and lumbar spine and hip. Porter found these were minor injuries under the Schedule, with no sign that the accident exacerbated any earlier complaint. He noted he had not been pointed to any medical opinion that a pre-existing condition would block her recovery within the MIG.
The non-earner benefit claim met the same fate. Under the Schedule, the benefit is payable where an insured suffers a complete inability to carry on a normal life, measured against the test set out in Heath v. Economical Mut. Ins. Co., 2009 ONCA 391. Ibrahim testified that pain limited her childcare, cleaning, cooking, hygiene, and prayer.
But her family physician's notes told a different story. Across appointments on January 11, January 16, February 26, May 3, June 14, and July 12, 2025, the doctor's records did not connect her concerns to the accident or document accident-related functional limits. On childcare, Porter noted her testimony was "extremely limited", and a January 16, 2025 note showed she had brought one of the children to the doctor. On cooking and cleaning, she identified no specific tasks she could not do. On hygiene, needing help into a shower chair did not show a complete inability to carry on a normal life.
Porter found Ibrahim had not detailed her pre-accident function well enough to show her activities were impaired to a substantial degree. While he accepted some tasks were affected, he was not convinced they amounted to substantially all of her normal pre-accident life.
With the injuries minor and the funding limit reached, the disputed physiotherapy plan fell outside the $3,500.00 cap and was denied. Because no benefits were owing, no interest applied.
For claims professionals, the decision is a clean illustration of how documentation drives MIG and non-earner outcomes. The applicant's account of her limitations was not corroborated in the clinical notes, and that gap, not the severity of the accident, decided the case.
