What happened: An Ontario tribunal kept a rear-ended driver inside the $3,500 minor injury cap.
Who's involved: The driver and his auto insurer, Belair Insurance Company Inc.
What's at stake: Three chiropractic plans and three $2,200 assessments beyond the $3,500 limit.
Why it matters: Months of pain notes lost out to a full insurer assessment and a light treatment history.
Where it stands: Decided - the tribunal dismissed the application on September 24, 2026.
More than a year after his car was rear-ended, a driver was still telling his doctor his shoulder hurt. The tribunal believed him. He stayed under the $3,500 minor injury cap anyway.
Ontario's Licence Appeal Tribunal released the decision on September 24, 2026, siding with Belair Insurance Company Inc. on every issue it ruled on. Belair had handled the claim under the Minor Injury Guideline, or MIG, the rule that caps medical and rehab funding at $3,500 for sprains, strains and similar soft-tissue injuries.
The driver wanted more. He said chronic pain and psychological injuries put him outside the cap, and he asked for three chiropractic plans plus orthopaedic, psychological and chronic pain assessments at $2,200 apiece.
The crash happened on January 14, 2024. Two days later, his family doctor noted tenderness in his right shoulder, chest wall and lower back. Imaging showed mild wear in a shoulder tendon. No tear, no fractures.
The pain hung around. His doctor's notes track shoulder complaints through 2024 and into the summer of 2025, and the tribunal accepted he had been in pain for more than a year.
Here's the catch. "The persistence of pain alone does not automatically establish chronic pain warranting removal from the MIG," the tribunal wrote.
What carried more weight was the insurer's orthopaedic surgeon. Across three reports from June 2024 to June 2025, he kept reaching the same verdict: uncomplicated strains in the neck and lower back.
The treatment record pointed the same way. It was physiotherapy, medication and check-ins with the family doctor - no referral to a musculoskeletal specialist and no invasive pain treatment.
Then there was day-to-day life. Nothing in the file showed the pain stopped him from looking after himself, keeping house or holding down work, and no doctor explained how it did.
The psychological side had more colour. At an April 2024 pre-screening, the driver said he hadn't gone back to driving and felt significant anxiety riding as a passenger. He described nightmares, flashbacks, poor sleep and trouble concentrating.
The psychological associate who saw him gave provisional diagnoses, including post-traumatic stress disorder, and recommended a full assessment. His family doctor also logged a fear of driving that May.
The tribunal accepted he had these symptoms. It still went with the insurer's psychologist, who assessed him in May 2025 and found no psychological condition that warranted treatment outside the MIG.
It came down to depth. The pre-screen "was intended as a screening tool and expressly contemplated further assessment before reaching any definitive conclusions," the tribunal said.
One question never got answered at all. A July 2025 case conference had flagged whether the driver was barred because he "wilfully made a material misrepresentation" on his benefits application. Belair expressly withdrew that issue, so the tribunal never ruled on it.
The rest fell into place quickly. With the driver inside the cap, the tribunal didn't need to weigh the six disputed plans. No benefits were owed, so no interest. And with nothing unreasonably held back, there was no award, which can reach 50 per cent of benefits payable under s. 10 of Regulation 664.
Application dismissed.
On MIG files, a full insurer assessment and a conservative treatment history can count for more than a long run of pain notes or an early psychological screen, so the thoroughness of the medical evidence on each side is often what tips the result.
The decision does not say whether either party plans to seek reconsideration or appeal.
