Ontario's Licence Appeal Tribunal has reopened a Minor Injury Guideline dispute against Aviva, ruling an adjudicator failed to weigh a claimant's neurological impairment.
The reconsideration decision, released July 16, 2026, granted the claimant's request in part and cancelled part of an earlier ruling, sending several issues to a fresh hearing before a new adjudicator.
The dispute traces back to a June 16, 2019 accident. The claimant sought benefits under the Statutory Accident Benefits Schedule and, after a written hearing, was held to the Minor Injury Guideline - the framework that limits treatment to $3,500 for predominantly minor injuries. The original decision, released March 27, 2026, also found her statute-barred from one of four disputed treatment plans under section 56, and denied the remaining three plans, an award, and interest.
On reconsideration, the claimant argued the Tribunal erred by overlooking a physician's diagnosis of "mild chronic right C5-7 radiculopathy." Neurological impairments fall outside the Schedule's definition of a minor injury, yet she said the Tribunal assessed her diagnosis only through the lens of chronic pain and psychological impairments - never as a standalone neurological issue.
The Vice-Chair agreed. He found the Tribunal erred in handling the neurological arguments, and that the error would likely have changed the result. An established, accident-related neurological impairment, he noted, can merit removal from the Minor Injury Guideline on its own, separate from chronic pain or psychological considerations.
The decision stressed that a decision-maker need not address every submission but must engage a party's key arguments. Aviva had countered that its analysis was thorough and that no rule requires every submission to be addressed explicitly. The Vice-Chair accepted the general principle but found a central plank of the claimant's MIG argument had gone unaddressed.
Rather than simply removing the claimant from the guideline, the Vice-Chair sent the remaining substantive issues to a new adjudicator. Those include disputed psychological and physiotherapy plans, a possible award for benefit payments the insurer allegedly withheld or delayed unreasonably, and interest. The new adjudicator will decide them on the existing written record.
One part of the original decision survived. The Vice-Chair upheld the finding that the claimant was statute-barred under section 56 from pursuing one physiotherapy plan, treating her challenge to the insurer's denial letter as an attempt to reargue the evidence. That plan will not proceed to the rehearing.
The reasoning signals that where medical evidence points to an accident-related neurological impairment, that argument must be squarely addressed in a Minor Injury Guideline analysis rather than absorbed into chronic pain or psychological findings.
