A recent License Appeal Tribunal (LAT) decision was in favor of the Applicant by removing him from the MIG and thus ensuring coverage for medical benefits. The LAT decision in Zeineddine v. Economical Mutual Insurance Company, 2025 CanLII 13542 (ON LAT) empowers the strong medical evidence while also highlighting the limitations of insurer-funded medical assessments.
The Applicant was involved in a collision in 2020 and was diagnosed with a concussion, Post-Traumatic Stress Disorder, and depression by his treating doctors. However, despite his diagnosis being well documented, Economical Mutual Insurance Company took the position that the Applicant’s injuries fell within the Minor Injury Guideline thus only entitling him to $3,500 for treatment. Economical was relying on insurer medical examinations (IME) that failed to acknowledge the Applicant’s concussion.
The LAT Adjudicator, Julian DiBattista, noted in his decision that the IME assessors failed to acknowledge the diagnosis and thus placed no weight on the IME report.
As a result, the Applicant was awarded funding for essential treatments, including occupational therapy, psychological assessment, massage therapy and social rehabilitative counselling with some income replacement benefits.
If you or a loved one have been injured in a collision, you may be entitled to receive the help you deserve. Contact us at JEWELL RADIMISIS JORGE LL.P. and a member of our team will be happy to assist you.