What happened: An Ontario tribunal dismissed a driver's bid to recover five separate accident-benefit costs Aviva had refused to pay
Who's involved: Aviva Insurance Company of Canada defended against claims tied to Total Recovery Rehab Centre and Somatic Assessments invoices
What's at stake: $102.47, two claims of $464.44, and two of $1,855.92 in denied physiotherapy and psychotherapy costs
Why it matters: Shows insurers can pay psychotherapists less than psychologists and still win on short denial notices
Where it stands: Decided - the tribunal dismissed the application in full on September 22, 2026
Her physiotherapy and psychotherapy bills were already partly paid. She fought her insurer for the rest - and lost on every single point.
The driver was hurt in a car accident in May 2024. She claimed accident benefits from Aviva Insurance Company of Canada for physiotherapy and psychotherapy treatment. Aviva paid part of each bill but refused the rest. The standoff over five treatment plans ended up before Ontario's Licence Appeal Tribunal.
In total, she disputed five amounts. One was $102.47 for a physiotherapy reassessment at Total Recovery Rehab Centre. Two others were $464.44 each, for progress reports and travel costs. The last two were $1,855.92 each, for psychotherapy sessions through Somatic Assessments.
She also wanted a penalty against Aviva for allegedly dragging its feet on payments, plus interest.
Every claim failed.
The biggest dispute was over money. Her psychotherapist at Somatic Assessments billed $149.61 an hour - the rate Ontario's fee guideline sets for psychologists. Aviva paid $99.75 an hour instead, the rate set for occupational therapists and physiotherapists, and wouldn't move.
The Tribunal backed Aviva. Ontario's fee guideline doesn't set a rate for psychotherapists - they're not regulated like psychologists are, so insurer and claimant are supposed to work out a number between them. They couldn't, which left the adjudicator to decide what the sessions were actually worth.
A psychologist needs a doctoral degree and registration with Ontario's psychology college. That gap, the adjudicator found, justified the lower rate. Aviva, for its part, argued the fee it was already paying “arguably exceeds any mandated hourly rate for psychotherapists.”
The therapist was never going to earn psychologist money.
She tried a second argument, too: that Aviva's denial notices were too vague to count, and should have meant Aviva had to pay up no matter who was actually right.
The Tribunal disagreed. Citing two Ontario Court of Appeal rulings, it found a weak denial notice doesn't let a claimant skip proving her case. Even the notice rejecting her travel claim counted as clear enough to respond to. Her round trip to the clinic, it noted, came to under nine kilometres - well short of the distance needed to trigger reimbursement.
None of the five claims survived.
A provider's invoice description alone doesn't decide what's reasonable and necessary, and a short denial notice that points to the fee guideline just survived five separate challenges in one file.
The ruling is specific to this claimant's own paperwork and billing. It doesn't rewrite the province's fee guideline, and nothing in the decision says whether she's asked for a second look or an appeal.
