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Sothilingam v Definity Insurance Company, 2026 CanLII 29573 (ON LAT),

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Case Summary

In Sothilingam v. Definity Insurance Company, the issues in dispute were whether the Applicant’s injuries fell outside the Minor Injury Guideline (MIG), whether he was entitled to payment of a disputed physiotherapy OCF-18, along with interest on any overdue benefits. The Tribunal found that the Applicant’s injuries were limited to sprain and strain-type injuries falling within the MIG, and therefore he was not entitled to removal from the MIG, the treatment plan, or interest.

read the full decision here https://canlii.ca/t/kk786

The Tribunal found that the Applicant’s injuries remained confined within the MIG, as such, the disputed treatment plan for physiotherapy services was not necessary to be considered, andno interest was owing.

Vice-Chair Julian DiBattista, agreeing with Definity’s submissions, found that the Applicant failed to establish that his injuries fell outside the MIG. The medical evidence, including a family physician note, physiotherapy report, and a disability certificate, described sprain and strain injuries affecting the cervical spine, lumbar spine, sacroiliac joint, and thumb, along with headaches. These injuries fall squarely within the definition of “minor injury” under the SABS. The Tribunal noted the absence of any diagnosis of chronic pain or how the pain was of a severity or nature that caused functional impairment sufficient for a MIG removal.

The Tribunal was not persuaded by the Applicant’s submissions that he could not return to work or resume normal activities, as these claims were not supported by sufficient medical evidence. Additionally, Vice-Chair Julian DiBattista stated that the Applicant referenced case law but did not connect it to the facts or evidence. As a result, the Tribunal concluded that the Applicant did not meet his burden of proving, on a balance of probabilities, that he should be removed from the MIG.

As the Applicant remained within the MIG, the Tribunal determined that it was unnecessary to assess the reasonableness and necessity of the disputed physiotherapy treatment plan, as funding was limited within the MIG framework. Finally, since no benefits were found to be payable, the Applicant was not entitled to interest. The Application was therefore dismissed in its entirety.

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