A Toronto welder waited too long to fight TD General Insurance's denials - and a two-year deadline, not his injuries, sank most of his claim.
The Ontario Licence Appeal Tribunal dismissed the application on July 17, 2026, handing TD General Insurance Company a win on both a limitation defence and Ontario's $3,500 Minor Injury Guideline (MIG). For claims professionals, the decision is a reminder that a clear, compliant denial letter starts the two-year clock - and that a late dispute can close a file before the medical evidence is ever weighed.
The applicant, then 24 and working full-time as a welder and general labourer, was driving alone when he rear-ended another vehicle on Highway 401 in Toronto on May 6, 2023. No airbags deployed, police attended, and he did not go to hospital. He returned to work on May 9, 2023.
He later sought a non-earner benefit of $185.00 per week, treatment beyond the MIG, and several assessments, including psychological ($2,144.93), chiropractic ($3,122.30) and chronic pain ($2,164.00) plans. TD denied the benefits, and he applied to the Tribunal.
Timing decided most of it. Under section 56 of the Statutory Accident Benefits Schedule, a claimant has two years from a proper denial to dispute it. TD argued its June 16, 2023 letter validly denied the non-earner benefit, telling the applicant in plain terms that "you no longer are eligible for the Non-Earner Benefit," along with the steps and time limits to dispute.
The applicant countered that the notices were not clear denials under the Supreme Court's test in Smith v. Co-operators, which requires straightforward language aimed at an unsophisticated reader, plus an explanation of the dispute process and its time limits. Adjudicator Bernard Trottier disagreed, finding the letter's declarative wording something an unsophisticated person could read as a denial.
The application reached the Tribunal on October 28, 2025 - about 28 months after that denial. Requests to revive the psychological and chiropractic plans came later still, at a February 2026 case conference. Trottier found the disputes statute-barred and, because the applicant made no submissions on the factors that can justify an extension, declined to extend the limitation period.
On the issues that remained live, the applicant stayed inside the MIG. Trottier found his pain complaints intermittent and unaccompanied by pain medication, and not severe enough to prompt further care; his functional limits, the adjudicator noted, extended mainly to sports such as basketball. The applicant had continued working - as a welder and later as a ride-share driver - and kept up his daily activities.
The psychological claim also failed. The insurer's examining psychologist found no formal psychological condition and no post-traumatic stress, and the applicant's own account of his mental health, along with his increased driving after the crash, undercut the claim. Trottier gave little weight to a single psychological note in the nurse practitioner's records.
With his injuries classed as minor, the chronic pain assessment was not payable. Trottier also found no basis for an award under section 10 of Regulation 664, concluding TD did not unreasonably withhold or delay payment. The application was dismissed.
