What happened: The tribunal upheld Intact's refusal to pay more than $13,000 in disputed treatment, finding the claimant's injuries were minor.
Who's involved: Intact Insurance Company, a self-represented driver, and treatment providers Downsview Healthcare and Physiomed Bramalea.
What's at stake: Six treatment plans worth roughly $13,233 in psychological, chiropractic and physiotherapy care.
Why it matters: Proving an injury isn't minor is the claimant's job, and the tribunal won't do that work for him.
Where it stands: Decided - the Licence Appeal Tribunal dismissed the application on September 18, 2026.
A driver chasing more than $13,000 in treatment gave Ontario's accident benefits tribunal exactly nothing in the way of medical proof.
He'd sought physiotherapy, chiropractic care and a psychological assessment after a car accident on April 16, 2023. Intact Insurance Company said no, capping his coverage at $3,500 under the province's Minor Injury Guideline - the cap reserved for sprains, strains and other soft-tissue injuries. The fight landed before the Licence Appeal Tribunal.
The disputed plans came from two providers. Downsview Healthcare billed $2,486 for a psychological assessment, $3,308 for chiropractic care and another $2,486 for a chronic pain assessment. Physiomed Bramalea added three physiotherapy plans worth $4,953.25 combined. All in, Intact was looking at a bill of more than $13,000 if the driver won.
Escaping the MIG cap is the claimant's job, not the insurer's. He needed to show his injuries went beyond a simple sprain or strain - through a clinical report, chronic-pain findings, anything connecting his symptoms to something outside the guideline.
None of that showed up. The tribunal found no medical evidence anywhere in his hearing materials, just arguments that he deserved more. Building that case isn't the tribunal's job, and it said so plainly.
He'd also been represented by a lawyer earlier in the case before ending up self-represented by the time of the hearing - one more sign of how thin the file had become.
Intact had raised its own wrinkle, arguing the driver shouldn't even get a hearing on the psychological assessment plan because he'd skipped a mandatory insurer's exam. The tribunal never had to rule on it. Once the MIG finding went against him, every other issue fell away too, including his push for interest and for a ruling that Intact had unfairly dragged its feet on paying him.
There was a smaller skirmish, too. After the driver filed his submissions, Intact tried to get them thrown out by email, pointing to a missed deadline. No luck. Without a formal motion, the tribunal said there was nothing to rule on.
It's a pattern SABS adjusters know well. A MIG dispute lives or dies on paper, not on how reasonable the ask sounds. Arguments alone won't move the needle without something clinical behind them.
Procedure matters too. Trying to strike a filing by email, instead of filing a proper motion, didn't work either.
