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Aviva Insurance Company of Canada v. J.A. (2021 ONSC 3185)

  • April 30, 2020

The insurer appealed the Tribunal’s decision that it was required to pay for the claimant’s catastrophic impairment assessments even though the assessments were not requested or completed until after submission of the OCF-19 and the catastrophic impairment IEs. The insurer characterized the requested assessments as rebuttal reports, which were not payable under the current version of the SABS. The Court dismissed the appeal, holding that the Tribunal did not make an error of law. The Tribunal made a finding of fact that the claimant had not obtained any earlier assessments, so the requested assessments were not rebuttal assessments. As a matter of law, section 25 was to be interpreted broadly, and the term “preparation” of a catastrophic impairment application did not end when the OCF-19 was submitted. Therefore, section 25 applied and required the insurer to pay for the claimant’s catastrophic impairment assessments.

Full decision here

TGP Analysis

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  • FILED UNDER CAT Assessments, Divisional Court
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