An Ontario tribunal admitted one late medical record and excluded another - then dismissed the underlying treatment plan entirely.
The Licence Appeal Tribunal's Automobile Accident Benefits Service ruled on a dispute involving TD General Insurance Company, in a decision released August 10, 2026. The applicant, hurt in a motor vehicle accident on January 7, 2023, sought $5,100.40 for chiropractic therapy, spinal decompression therapy and massage therapy proposed by Islington North Chiropractic in a treatment plan submitted September 19, 2024. TD General had denied the plan.
Adjudicator Melanie Malach first resolved a dispute over late-filed records. A Case Conference Report and Order dated August 20, 2025 required the parties to exchange productions within 30 days and any remaining reliance documents within 45 days. The applicant produced nothing until January 11, 2026 - 152 days after the case conference - when counsel served updated clinical notes and records from the applicant's family physician. Records from Islington North Chiropractic were disclosed later still, surfacing only within the applicant's written submissions.
Malach found the applicant breached the order and offered no explanation for either delay. Even so, she treated the two sets of records differently. The family physician's updated notes were admitted: TD General already held earlier records from the same physician, had relied on them in its own submissions, and received the update within a reasonable time once it was produced. The chiropractic clinic's records were excluded outright, since the insurer had no opportunity to assess or respond to them before the hearing, which Malach found "contrary to procedural fairness."
On the merits, the treatment plan fared no better. It covered an assessment, form completion, twenty sessions of chiropractic manipulation, twenty exercise sessions, twenty stimulation sessions, ten spinal decompression sessions and four massage sessions. TD General's examiner, a general practitioner, had concluded the applicant's injuries were minor and self-resolving. A treating orthopaedic surgeon had instead diagnosed chronic pain with central sensitization.
Malach preferred the insurer's examiner, finding it consistent with the applicant's own family physician's records, which she said showed only sporadic complaints and no documented functional limitations. She noted the applicant had not addressed the treatment plan's goals or explained why the specific recommendations were reasonable and necessary. The application was dismissed in full.
By the time of the ruling, TD General had already paid $12,178.87 in medical and rehabilitation benefits, with approved funding still unused under two earlier treatment plans. The applicant had switched providers after moving closer to Islington North Chiropractic, which Malach accepted as reasonable, though she found that alone did not entitle him to payment for a new plan assessed independently on its own merits.
