Tribunal charts its own course in Intact Insurance CAT dispute, finds moderate impairment across all domains
An Ontario Tribunal denied catastrophic impairment and income replacement claims against Intact Insurance - but not before rewriting the experts' homework.
In a decision released April 27, 2026, the Licence Appeal Tribunal dismissed all claims brought by Asma Khan against Intact Insurance Company following a November 30, 2017 automobile accident. Khan had sought a catastrophic impairment designation under Criterion 8 of the Statutory Accident Benefits Schedule, along with post-104-week income replacement benefits. The Tribunal denied both.
The case - Khan v. Intact Insurance Company, 2026 ONLAT 24-006070/AABS - raised a question gaining traction in Ontario auto insurance circles: can a psychologist play a central role in a Criterion 8 CAT assessment, or does the Schedule require a physician to do the heavy lifting?
Intact argued the latter. During closing submissions, the insurer challenged the admissibility of the CAT assessment conducted by psychologist Dr. Brian Levitt, pointing to s. 45(2)1 of the Schedule, which requires physician involvement. Intact relied on the Divisional Court's decision in Abboud v. Intact Insurance Co., 2025 ONSC 3416, where a CAT claim failed because there was no evidence the physician had been involved in the psychologist's work.
Adjudicator Caley Howard saw it differently. In Khan's case, the assessment report described how Dr. Melody Nguyen, a Physical Medicine Specialist, supervised the process - reviewing the medical file, selecting the assessment team, evaluating findings, and consulting with the team before reaching conclusions. That level of documentation, the adjudicator found, satisfied the statutory requirements. For insurers and assessment providers alike, the takeaway is straightforward: document the physician's supervisory role thoroughly, and a team-based approach can hold up.
On whether Khan was catastrophically impaired, the Tribunal charted its own course. Dr. Levitt rated Khan as markedly impaired in all four domains of functioning under the AMA Guides - activities of daily living, social functioning, concentration, persistence and pace, and adaptation. Dr. Ahmed Jwely, Intact's expert, found mild impairment in two domains and moderate in two others. The adjudicator landed on moderate impairment across the board - rejecting Dr. Levitt's and Dr. Jwely's ratings in two domains each, and aligning with Dr. Jwely's moderate ratings in the remaining two.
What shaped the outcome was a mix of retained ability and genuine struggle. Khan still drove independently, managed her own medication, completed a nursing diploma after the accident, maintained close family relationships, and lived on her own for most of the post-accident period. At the same time, she needed daily prompting for self-care and housekeeping, struggled with work-simulating tasks during an occupational therapy assessment, and reported considerable social isolation.
Because a catastrophic designation requires marked impairment in at least three domains - or extreme in one - Khan's claim fell short.
Her income replacement claim met a similar end. The post-104-week test requires proof of a complete inability to work in any role suited to the claimant's background. The Tribunal gave greater weight to a February 2020 multi-disciplinary insurer's examination that directly addressed this test, over expert opinions prepared for other purposes. Khan's treating psychiatrist's notes also indicated her symptoms were relatively well controlled by medication around that time.
The decision sends a clear reminder to claims teams: the Tribunal will not simply adopt an expert's opinion at face value. When the evidence tells a more nuanced story than either side's assessor acknowledges, the adjudicator will reach their own conclusions.
