An Ontario tribunal partially approved a $97,398.08 home modification claim for a catastrophically impaired teen, granting handrails and rejecting a full bathroom renovation.
In Jiang v. TD General Insurance Company, 2026 CanLII 51012 (ON LAT), released May 27, 2026, the Licence Appeal Tribunal partially approved a treatment plan dated June 25, 2023, ordering TD General Insurance Company to pay for a narrow set of safety modifications while denying the bulk of the proposed renovations.
The applicant, Wanghao Jiang, was four years old when he was in an automobile accident on September 5, 2012. He sustained a traumatic brain injury and was deemed catastrophically impaired under the Statutory Accident Benefits Schedule. By the hearing date, he was eighteen and no longer represented by a litigation guardian.
Adjudicator Tami Cogan accepted that Jiang continues to experience intermittent dizziness, fatigue, headaches, and poor balance, putting him at increased risk of falling. On that basis, she ordered TD to pay for bilateral handrailing on the exterior stairs at the front entry and releveling of the pre-cast concrete steps, bilateral handrailing on the staircase between the main level and the second level, bilateral handrailing on the staircase between the main level and the basement, and bilateral handrailing on the steps from the basement patio door to the patio.
The remainder of the plan was denied. Cogan rejected a proposal to raise the front porch and add a guardrail, finding it would merely transfer the trip hazard rather than eliminate it. A full main bathroom renovation - curb-less shower, comfort height toilet, and non-slip tiles - was found not reasonable and necessary. The applicant did not endorse falling in the bathroom, did not use mobility aids requiring a curb-less entry, and the existing toilets in the main and ensuite bathrooms were already raised and elongated. The respondent's expert pointed to less costly alternatives, including cut-out tubs and a floor-to-ceiling transfer pole.
A proposed deck and exterior stairs from the kitchen were also denied. Cogan preferred the respondent's evidence that the interior route to the existing walk-out patio door was safer than exterior stairs exposed to weather, and noted Jiang's own testimony that he would not use the deck. A replacement patio door and new backyard patio were rejected because the existing patio was found to be level and not a falling risk. A basement therapy room was denied because Jiang's school grades were strongly persuasive that his existing desk and noise-cancelling headphones already supported his concentration.
Jiang sought a special award under s. 10 of Reg. 664, arguing the insurer blindly followed its Insurer's Examination assessors and ignored medical evidence. Cogan disagreed. She found the medical evidence contained contradictory opinions and that the respondent was entitled to rely on its IE assessors' conclusions, even where the applicant disagreed.
A request for costs against the respondent's counsel - based on two cross-examination questions directed at the applicant's mother - was also denied. While the questions caused emotional discomfort, Cogan found they were in line with the respondent's theory of the case and did not prejudice the applicant or interfere with the Tribunal's process.
Interest applies on any overdue payment under s. 51 of the Schedule.
