Mojtaba Jorabian v. Definity Insurance Company, 2026 CanLII 29565

Licence Appeal Tribunal

Citation: Jorabian v. Definity Insurance Company, 2026 ONLAT 24-013188/AABS

Licence Appeal Tribunal File Number: 24-013188/AABS

In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.

Between:

Mojtaba Jorabian

Applicant

And

Definity Insurance Company

Respondent

DECISION

ADJUDICATOR: Rebecca Hines

APPEARANCES:

For the Applicant: Peter Cimino, Counsel

For the Respondent: Camilla Oblak, Counsel

HEARD: By way of written submissions

OVERVIEW

1Mojtaba Jorabian, the applicant, was involved in an automobile accident on October 25, 2022, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, Definity Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

1. Are the applicant’s injuries predominantly minor as defined in s. 3 of the Schedule and therefore subject to treatment within the $3,500.00 Minor Injury Guideline (“MIG”) limit?
2. Is the applicant entitled to $290.95 ($1,298.59 less $1007.64 approved) for chiropractic and massage therapy services, proposed by Body Dynamics in a treatment plan (“OCF-18”) dated February 28, 2023?
3. Is the applicant entitled to $4,067.72 for physiotherapy/chiropractic and massage services, proposed by Body Dynamics in a OCF-18 dated March 30, 2023?
4. Is the applicant entitled to interest on any overdue payment of benefits?

3The applicant withdrew an OCF-18 for a psychological assessment in the amount of $2,219.74 as an issue in dispute. Consequently, this issue will not be addressed in this decision.

RESULT

4After considering both parties’ submissions and evidence, I find the applicant sustained a minor injury and is subject to treatment within the MIG limit. He is not entitled to the OCF-18s in dispute or interest.

PROCEDURAL ISSUE

5The respondent requested that the clinical notes and records from Body Dynamics, the applicant’s treating clinic (from February 2025) be given little weight because they were first served on it with his written submissions, which was in non-compliance with the Tribunal’s case conference report and order. In light of my decision in this matter, I find it unnecessary to address this issue further because this evidence had no bearing on the outcome of this decision.

ANALYSIS

The applicant sustained a minor injury and is subject to treatment within the MIG

6Section 18(1) of the Schedule sets out that medical and rehabilitation benefits are limited to $3,500.00 if the insured person sustains an impairment that is predominantly minor in accordance with the MIG. Section 3(1) defines a “minor injury” as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury.”

7An insured person may successfully be removed from the MIG if they can establish that their accident-related injuries fall outside of the MIG or, pursuant to s. 18(2), that they have a documented pre-existing injury or condition combined with compelling medical evidence stating that the condition prevents recovery if they are kept within the MIG. The Tribunal has also determined that chronic pain with functional impairment or a diagnosed psychological condition may justify removal from the MIG. The applicant bears the onus of proving on a balance of probabilities that his accident-related impairments fall outside of the MIG.

8The applicant argues that he suffers from chronic pain as a result of the accident which removes him from the MIG. He relies on the CNRs of Body Dynamics, his treating clinic in support of his position.

9The respondent submits that the medical evidence relied upon by the applicant does not support that he suffers from chronic pain.

10I find the applicant has not met his onus in proving that he suffers from chronic pain as a result of the accident for the following reasons.

11First, I find the evidence relied upon by the applicant insufficient to support that he suffers from chronic pain as a result of the accident. The applicant solely relies on the CNRs of his treating clinic in support of his position that he suffers from ongoing back and shoulder pain. I do not find this evidence persuasive because for the most part, the notes are not legible, and there is no reference to any functional limitations as a result of ongoing pain in these records. The law is well established that functional impairment is required to be removed from the MIG due to chronic pain. Overall, I find the CNRs establish that the applicant attended the clinic for treatment.

12Second, the applicant relies on the Tribunal’s decision in T.S. v Aviva, 2018 CanLII 83520 (ON LAT) in support of his position that he should be removed from the MIG due to chronic pain. I find this decision does not support his position because Executive Chair Lamoureux highlighted that any pain complaints must be more than sequelae of soft tissue injuries. It must have an adverse impact on an individual’s well being and be functionally disabling. As highlighted above, the applicant has not submitted any evidence to support that he has any physical impairments resulting in functional limitations.

13I conclude that the applicant has not met his onus in proving on a balance of probabilities that he suffers from chronic pain as a result of the accident which would remove him from the MIG.

14The applicant is not entitled to the OCF-18s in dispute because they both seek treatment outside of the MIG, and there is only $92.79 remaining in the MIG limit.

The applicant is not entitled to interest

15Interest applies on the payment of any overdue benefits pursuant to s. 51 of the Schedule. The applicant is not entitled to interest because I have not determined that any benefits are overdue.

ORDER

16For the above-noted reasons, I order as follows:

1. The applicant sustained a minor injury and is subject to treatment within the MIG limit. He is not entitled to the OCF-18s in dispute or interest.
2. This application is dismissed.