Definity Must Fund Psychological Assessment After Losing MIG Classification Bid
A Canadian court or arbitration body has ordered Definity Financial to pay for a psychological assessment after the insurer failed in its attempt to keep a claimant's injuries within Ontario's Minor Injury Guideline (MIG). The ruling underscores how insurers must sometimes absorb diagnostic costs when their efforts to cap payouts under the MIG framework are unsuccessful.
What happened
A legal decision has ordered Definity Financial to cover the cost of a psychological assessment for an accident benefits claimant. The insurer had attempted to have the claimant's injuries classified under Ontario's Minor Injury Guideline (MIG), which caps payouts for certain soft-tissue and less severe injuries, but its bid was rejected. Following the loss, the adjudicator directed the insurer to pay for the assessment.
What it means for consumers
Claimants dealing with insurers that try to fit psychological injuries into the MIG cap may have stronger leverage when challenging those classifications. When an insurer's MIG argument fails, the cost of obtaining the very evidence needed to prove a more serious injury can be shifted back to the insurer. This can lower a significant financial barrier for injured people seeking treatment for mental health concerns arising from an accident.
What it means for premiums
No direct premium change has been announced.
Coverage considerations
The decision reinforces that accident benefit claims involving psychological harm can fall outside the MIG's standardized cap when the evidence supports a more serious category of injury. Insurers may need to budget for independent medical examinations and psychological assessments when they elect to contest MIG applicability. Policyholders should expect that the scope of available benefits, including coverage for psychological care, can hinge on whether injuries are ultimately deemed minor or catastrophic under provincial accident benefits rules.