Missed tolling deadline sinks driver’s income benefits claim against Definity

He skipped two CT scans - then sought a $20,088 catastrophic impairment assessment
Missed tolling deadline sinks driver’s income benefits claim against Definity
LEGAL INSIGHTS
By Gladys Jalipa
Oct 19, 2026

What happened: An Ontario tribunal enforced a tolling agreement's refiling date and barred a driver's income benefits claim.

Who's involved: Definity Insurance Company and a driver hurt in a 2021 roundabout crash.

What's at stake: $400 a week in income replacement benefits, plus treatment and assessment plans totalling $28,894.22.

Why it matters: Withdrawing an application doesn't stop the limitation clock, and a clear refiling date sticks.

Where it stands: Decided October 5, 2026. Definity won on every issue.

 

The deal was simple: refile by December 31, 2024, and the clock stays paused. He refiled in April 2025.

That missed date cost an Ontario driver his claim for $400 a week in income replacement benefits from Definity Insurance Company. The Licence Appeal Tribunal, in a decision released October 5, 2026, held him to the date he'd agreed to and ruled the claim came too late.

His treatment claims didn't fare any better. The tribunal kept him inside the Minor Injury Guideline and its $3,500 funding cap.

A deal with a deadline

It started at a roundabout at about 1:45 a.m. on September 26, 2021, when another vehicle entered and struck the rear passenger side of his car. He didn't seek medical attention right away and was able to drive the car afterward.

Definity turned down his income replacement benefits on November 25, 2022. That gave him two years, under section 56 of the Statutory Accident Benefits Schedule, to take the dispute to the tribunal.

He did, around June 30, 2023. Then he withdrew.

On August 25, 2024, the two sides signed a tolling agreement - in plain terms, the insurer's promise to pause the limitation clock. The catch was in clause 2: the limitation periods “will toll, and remain protected, provided that” he reapplied to the tribunal by December 31, 2024.

The agreement itself names Economical, part of the Definity Financial family since 2021.

His new application landed around April 14, 2025.

The clock kept running

His argument was that the first filing in June 2023 already beat the limitation period, so the tolling agreement never set a new deadline. He also said the agreement didn't spell out what would happen if he refiled late. He didn't cite any case law.

Definity's answer: if that first filing had been enough, nobody would have needed a tolling agreement. Without a hard stop, the insurer said, a claimant would be “free to withdraw and re-apply however many times, and for however long he wishes.”

The tribunal agreed with Definity, leaning on two earlier tribunal rulings. Pulling an application, it said, doesn't stop the clock. “It would be absurd to find that an insured person can skirt the limitation period simply by filing an application with the Tribunal and then subsequently withdrawing the application prior to a hearing on the merits,” the vice-chair wrote.

The refiling clause was “unambiguous,” the tribunal said, and the claimant “must now accept the consequences for not filing an application in the requisite time.”

The tribunal does have the power to extend a missed deadline when there are reasonable grounds. He never asked it to.

Two missed scans

The treatment claims went the same way. Definity had placed him in the Minor Injury Guideline, which covers injuries like sprains, strains and whiplash. He said he was dealing with chronic pain and psychological injuries, and asked Definity to fund a $4,794.72 chiropractic plan, a $20,088 catastrophic impairment assessment and a $4,011.50 mental health assessment.

His written arguments didn't help. The tribunal said they made only “boilerplate reference” to psychological effects and reduced function, without pointing to any evidence. He used all 10 pages he was allowed, then tacked on a two-page records summary outside the limit - despite an order requiring references “by tab and page number.”

The tribunal read the summary anyway. It didn't change the outcome.

Then there were the scans. An x-ray after the crash showed no sign of acute fracture, and he was referred for a CT scan of his neck and back. He missed the appointment.

It was rebooked for January 23, 2022. He missed that one, too.

That lack of follow-through, the tribunal said, “suggests that his injuries from the accident are minor.”

His family doctor's records showed anxiety linked to workplace stress that started before the crash. The only accident-related visit came more than two months afterward, and that entry didn't mention the accident. He also reported no significant driving anxiety at any point.

The tribunal concluded his psychological symptoms more likely stemmed from workplace issues and other life stressors, and at most were side effects of a minor injury that the guideline already covers. A physiatrist who examined him for the insurer found sprain and strain injuries and a normal neurological exam. With a minor injury, the tribunal said, a catastrophic impairment assessment wasn't reasonable and necessary.

No benefits owing meant no interest and no special award. Definity walked away owing nothing on any of it.

When a tolling agreement sets a clear refiling date, adjusters can expect the tribunal to enforce it - and a withdrawn application won't buy a claimant extra time on the two-year clock.

The decision does not indicate whether either party will seek reconsideration or appeal.

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