A claimant's psychological injury freed him from TD General Insurance's minor-injury cap, yet the insurer escaped any penalty for handling the claim.
Ontario's Licence Appeal Tribunal released its decision in Torgbor v TD General Insurance Company, 2026 CanLII 56654 (ON LAT) on June 5, 2026, in a dispute over statutory accident benefits.
Eric Torgbor was hurt in a car accident on December 16, 2022, and sought benefits from TD General Insurance. The insurer treated his injuries as predominantly minor, capping his medical and rehabilitation benefits at $3,500 under the Minor Injury Guideline. Torgbor argued an accident-related psychological impairment should remove him from that limit.
Adjudicator Timothy Porter agreed. He found, on a balance of probabilities, that Torgbor's injuries were not minor because of a psychological impairment, relying on a report from registered psychologist Dr. Toneatto, who diagnosed somatic symptom disorder with predominant pain, an adjustment disorder, and an unspecified trauma and stressor-related disorder. Clinical notes from a walk-in clinic Torgbor regularly attended recorded complaints of low mood, anxiety, and insomnia, along with prescriptions for anxiety and insomnia.
The insurer relied on section 44 assessments by its own psychologist, Dr. Cobrin, and a general practitioner, Dr. Bansal. Porter assigned lesser weight to Dr. Cobrin's report. He noted that Dr. Cobrin administered only one psychometric test, which the report itself described as designed for native English speakers, which Torgbor is not. Porter also identified discrepancies between Dr. Cobrin's original report and his addendum that he found could not be reconciled.
The insurer questioned causation, pointing to a physical assault that occurred after the accident as a possible source of the symptoms. Porter rejected that theory, finding it strained credulity given that Torgbor reported no psychological symptoms before the crash. He concluded the accident caused the mental health complaints.
With Torgbor out of the MIG, Porter found him entitled to a psychological assessment proposed by Q Medical and a psychiatric assessment, both of which the insurer had denied citing his MIG status. He also approved a treatment plan that was largely physiotherapy, accepting the physiotherapist's view that psychological symptoms were impeding physical recovery. Two chiropractic plans were denied, one because no evidence of the plan was filed and the other because it duplicated an already-approved assessment. Interest was ordered on overdue payments.
Torgbor also sought an award under section 10 of Regulation 664, which lets the Tribunal grant up to 50 per cent of benefits payable where an insurer unreasonably withholds or delays payment. He argued the insurer favoured its section 44 conclusions over contrary medical records. Porter disagreed, noting the insurer had its assessor review the new evidence in an addendum.
"An award is for serious misconduct, not a difference in opinion or a mistake," Porter wrote, finding no conduct that justified one.
