Insurer The Personal Insurance Company beat a claimant's reconsideration bid after an Ontario tribunal refused to comb 424 pages of unflagged clinical records.
In Hemming v. The Personal Insurance Company, 2026 CanLII 59488 (ON LAT), released June 12, 2026, the Licence Appeal Tribunal dismissed Hemming's request to reconsider a February 17, 2026 decision arising from a February 11, 2023 accident. She had sought benefits under the Statutory Accident Benefits Schedule.
The original hearing put twelve denied treatment plans, an award, and interest in dispute. The Tribunal granted two plans plus interest and denied the rest. On reconsideration, Hemming pressed two plans from Do Axis Therapy and Performance: $1,900.00 for chiropractic and physiotherapy dated April 8, 2024, and $4,963.80 for massage, chiropractic and physiotherapy dated June 27, 2024.
Hemming relied on Rules 18.2(a) and 18.2(b), arguing a breach of procedural fairness and an error of fact or law. Her core complaint was that the hearing adjudicator declined to consider clinical notes and records from Axis.
Adjudicator Nathan Prince was not persuaded. He noted the Case Conference Report and Order required submissions to reference evidence by tab and page number, and warned that non-compliant submissions might not be considered. Hemming's Document Brief ran to sixty-eight tabs totalling four thousand and thirty-two pages. Of fifty-three items referenced in her submissions, only thirteen were tied to a page number.
The Axis records alone totalled four hundred and twenty-four pages. Hemming's submissions pointed only to "numerous references to reduced pain and improvement," without identifying dates or search terms. Prince found that forcing an adjudicator to sift those pages and select supporting entries amounted to making the applicant's case for her, contrary to the binding Divisional Court ruling in Dooman v. TD Insurance Co.
The reasoning carries a clear message for claims professionals: the onus sits with the applicant to direct the Tribunal to its evidence, and that requirement held even though the records were chronological and searchable. Prince added that having the adjudicator pick relevant entries could itself raise fairness problems, leaving the respondent to speculate which records it had to meet.
On the error-of-fact ground, Hemming argued the Tribunal wrongly relied on a section 44 physiatry assessment by Dr. Rabinovich, whose opinion referenced an ultrasound report never received. Prince rejected that, finding the missing ultrasound did not stop Dr. Rabinovich from diagnosing and concluding the plans were not reasonable and necessary.
He also noted the decision did not turn on Dr. Rabinovich alone. The hearing adjudicator had placed little weight on a report from Dr. Getahun, which gave no basis for its recommendations, and found Dr. Finlayson and Dr. Sivapatham's opinions were not contemporaneous with the plans. The disputed plans recommended 80 physical rehabilitation sessions over a 22-week period.
Prince further observed that the plans were also denied for insufficient evidence that their costs were reasonable. Hemming's reconsideration request was dismissed.
