{"id":918641,"date":"2026-10-03T04:22:10","date_gmt":"2026-10-03T04:22:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/918641\/"},"modified":"2026-10-03T04:22:10","modified_gmt":"2026-10-03T04:22:10","slug":"no-medical-evidence-sinks-drivers-13000-bid-against-intact","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/918641\/","title":{"rendered":"No Medical Evidence Sinks Driver&#8217;s $13,000 Bid Against Intact"},"content":{"rendered":"<p>\n                        A driver wanted $13K in treatment covered &#8211; but never showed up with proof\n                    <\/p>\n<p>                            <img decoding=\"async\" src=\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2026\/10\/0343_639265689624144548.png\"   width=\"1000\" height=\"600\" alt=\"No Medical Evidence Sinks Driver's $13,000 Bid Against Intact\" fetchpriority=\"high\"\/><\/p>\n<p>What happened: The tribunal upheld <a href=\"https:\/\/www.insurancebusinessmag.com\/ca\/companies\/intact\/169997\/\" rel=\"nofollow noopener\" target=\"_blank\">Intact<\/a>&#8216;s refusal to pay more than $13,000 in disputed treatment, finding the claimant&#8217;s injuries were minor.<\/p>\n<p>Who&#8217;s involved: Intact Insurance Company, a self-represented driver, and treatment providers Downsview Healthcare and Physiomed Bramalea.<\/p>\n<p>What&#8217;s at stake: Six treatment plans worth roughly $13,233 in psychological, chiropractic and physiotherapy care.<\/p>\n<p>Why it matters: Proving an injury isn&#8217;t minor is the claimant&#8217;s job, and the tribunal won&#8217;t do that work for him.<\/p>\n<p>Where it stands: Decided &#8211; the Licence Appeal Tribunal dismissed the application on September 18, 2026.<\/p>\n<p>\u00a0<\/p>\n<p>A driver chasing more than $13,000 in treatment gave Ontario&#8217;s accident benefits tribunal exactly nothing in the way of medical proof.<\/p>\n<p>He&#8217;d sought physiotherapy, chiropractic care and a psychological assessment after a car accident on April 16, 2023. Intact Insurance Company said no, capping his coverage at $3,500 under the province&#8217;s Minor Injury Guideline &#8211; the cap reserved for sprains, strains and other soft-tissue injuries. The fight <a href=\"https:\/\/www.canlii.org\/en\/on\/onlat\/doc\/2026\/2026canlii100090\/2026canlii100090.html?resultId=fd05c666ba9e47dc8a68dfee1ba47cec&amp;searchId=2026-10-02T17:24:57:706\/7dacbb47b6fc4cb7b54ec19cee7d004a&amp;searchUrlHash=AAAAAQAJSW5zdXJhbmNlAAAAAAE\" rel=\"nofollow noopener\" target=\"_blank\">landed<\/a> before the Licence Appeal Tribunal.<\/p>\n<p>The disputed plans came from two providers. Downsview Healthcare billed $2,486 for a psychological assessment, $3,308 for chiropractic care and another $2,486 for a chronic pain assessment. Physiomed Bramalea added three physiotherapy plans worth $4,953.25 combined. All in, Intact was looking at a bill of more than $13,000 if the driver won.<\/p>\n<p>No file, no fight<\/p>\n<p>Escaping the MIG cap is the claimant&#8217;s job, not the insurer&#8217;s. He needed to show his injuries went beyond a simple sprain or strain &#8211; through a clinical report, chronic-pain findings, anything connecting his symptoms to something outside the guideline.<\/p>\n<p>None of that showed up. The tribunal found no medical evidence anywhere in his hearing materials, just arguments that he deserved more. Building that case isn&#8217;t the tribunal&#8217;s job, and it said so plainly.<\/p>\n<p>He&#8217;d also been represented by a lawyer earlier in the case before ending up self-represented by the time of the hearing &#8211; one more sign of how thin the file had become.<\/p>\n<p>The parts that never mattered<\/p>\n<p>Intact had raised its own wrinkle, arguing the driver shouldn&#8217;t even get a hearing on the psychological assessment plan because he&#8217;d skipped a mandatory insurer&#8217;s exam. The tribunal never had to rule on it. Once the MIG finding went against him, every other issue fell away too, including his push for interest and for a ruling that Intact had unfairly dragged its feet on paying him.<\/p>\n<p>There was a smaller skirmish, too. After the driver filed his submissions, Intact tried to get them thrown out by email, pointing to a missed deadline. No luck. Without a formal motion, the tribunal said there was nothing to rule on.<\/p>\n<p>It&#8217;s a pattern SABS adjusters know well. A MIG dispute lives or dies on paper, not on how reasonable the ask sounds. Arguments alone won&#8217;t move the needle without something clinical behind them.<\/p>\n<p>Procedure matters too. Trying to strike a filing by email, instead of filing a proper motion, didn&#8217;t work either.<\/p>\n","protected":false},"excerpt":{"rendered":"A driver wanted $13K in treatment covered &#8211; but never showed up with proof What happened: The tribunal&hellip;\n","protected":false},"author":2,"featured_media":918642,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[316434,49,48,84],"class_list":["post-918641","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-accident-benefits-minor-injury-guideline-intact-insurance","tag-ca","tag-canada","tag-health"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/918641","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=918641"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/918641\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/918642"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=918641"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=918641"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=918641"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}