An auto insurer's attempt to bar an accident benefits claim over missed medical examinations has failed at Ontario's Licence Appeal Tribunal.
In Adejumo v. TD General Insurance Company Inc., 2026 CanLII 53752 (ON LAT), Vice-Chair Trina Morissette ruled that TD General Insurance Company Inc. had not met its burden to show that the applicant, Fatimoh T. Adejumo, failed to attend insurer's examinations such that her claim should be barred.
Adejumo was involved in an automobile accident on May 1, 2022, and sought statutory accident benefits under the Statutory Accident Benefits Schedule. After TD denied her, she applied to the Tribunal to resolve the dispute.
The preliminary issue was whether Adejumo could proceed to a hearing after allegedly failing to attend insurer's examinations under section 44 of the Schedule. Section 44 lets an insurer require an insured person to be examined by regulated health professionals to determine entitlement to a benefit. Under section 55, an insured person cannot apply to the Tribunal if the insurer has given notice requiring a section 44 examination and the insured has not complied. The onus falls on the insured to provide a reasonable explanation for non-attendance.
On June 24, 2025, Adejumo submitted an OCF-19 seeking catastrophic impairment designation. TD denied the claim on July 10, 2025, saying assessments were needed to determine entitlement, and on August 12, 2025 advised that she had to attend examinations covering physiatry, neuropsychology, psychology and occupational therapy.
Adejumo did not attend the neuropsychological and psychological examinations scheduled for October 1, 2025. At her request, they were rescheduled to November 10, 2025. TD submitted that she again did not attend, and the examinations were moved to January 19, 2026.
At a November 28, 2025 case conference, the matter was set down for a five-day videoconference hearing, and a December 1 order set production deadlines. TD argued that proceeding with the examinations on January 19, 2026 would leave it unable to meet those deadlines. It said Adejumo's conduct caused significant delays and asked the Tribunal to dismiss her application, arguing her pattern of non-attendance suggested she did not intend to attend.
Adejumo did not dispute the validity of the notices. She argued TD had wilfully rescheduled the examinations, continued treating the claim as ongoing, and did not raise section 55 until the case conference. She noted there was no present non-compliance and no evidence she would skip the January 19 examinations.
Morissette found no evidence that Adejumo failed to attend the January 19, 2026 examinations. She held that TD's allegation was "pre-emptive and speculative." TD had not told the Tribunal in the four months since rescheduling that Adejumo missed those examinations, and neither party moved to vacate the preliminary issue hearing.
The Tribunal ordered the parties to proceed to a hearing on the substantive issues as previously scheduled. That five-day hearing was set to begin June 15, 2026. The decision was released June 4, 2026.
