An Ontario ruling confirmed insurers can suspend non-earner benefits when claimants refuse to provide updated medical information - even post-hearing.
In a decision released April 27, 2026, the Licence Appeal Tribunal sided with Aviva General Insurance Company in a dispute over whether the insurer could suspend non-earner benefits it had previously been ordered to pay on an ongoing basis.
The case, Aviva General Insurance Company v. Maharaj, 2026 ONLAT 24-010417/AABS, centered on a question that comes up more often than you might think in Ontario's accident benefits system: once a tribunal awards ongoing benefits, does the claimant still have to cooperate with the insurer's requests for updated information?
The answer, according to Vice-Chair Brian Norris, is a clear yes.
Here's the backstory. Nicholas Maharaj was in a car accident on March 28, 2017, and applied for non-earner benefits from Aviva under the Statutory Accident Benefits Schedule. Aviva denied the claim, and the matter went to the Tribunal. In a 2021 decision, the Tribunal found that Aviva's denial notice failed to comply with the Schedule, and awarded Maharaj non-earner benefits for the period from February 20, 2018 to March 28, 2019, and ongoing.
After that decision, Aviva did what insurers routinely do - it requested an updated disability certificate and asked Maharaj to attend insurer's examinations. He didn't comply with either request. Aviva suspended his benefits effective August 17, 2022.
Maharaj pushed back, arguing that section 281 of the Insurance Act shielded him from any reduction in benefits after a Tribunal decision. In his view, the earlier ruling locked in his entitlement, and Aviva had no business revisiting it.
Aviva saw it differently. The insurer argued it had an ongoing obligation to adjust the claim, and that requesting updated medical information under sections 33 and 37 of the Schedule was part of that duty - not a backdoor attempt to reduce benefits.
Vice-Chair Norris agreed with Aviva, drawing on reasoning from an earlier Tribunal decision in Balasubramaniam v. Aviva General Insurance Company (2023). He found that while section 281 does prevent insurers from unilaterally cutting benefits after a hearing, it doesn't relieve claimants of their obligation to respond to reasonable information requests.
The key distinction came down to this: suspension isn't the same as reduction. Under section 33(6) of the Schedule, an insurer isn't required to pay benefits during any period of non-compliance. But section 33(8) allows withheld amounts to be repaid if the claimant later complies and offers a reasonable explanation for the delay. A suspension, in other words, is temporary - not permanent.
Norris put it plainly: granting a claimant lifetime benefits simply because an insurer once issued a flawed stoppage notice would amount to "an unreasonable windfall." The ongoing nature of specified benefits like non-earner benefits, he wrote, means the claim can and should be revisited when reasonably necessary.
Maharaj sought an award under section 10 of Regulation 664, arguing Aviva unreasonably withheld his payments. That request was denied.
For insurers and claims professionals, the takeaway is straightforward: a Tribunal award of ongoing benefits does not excuse claimants from cooperating with legitimate requests for updated information. The right to adjust claims under the Schedule survives a hearing - and non-compliance can lead to a valid suspension of payments.
