Ontario Superior Court: Plante v Dynamic Functional Solutions Misrepresentation Struck

• The Ontario Superior Court struck direct claims for fraudulent and negligent misrepresentation against a medical assessment firm and its professionals in an SABS case.
• The court found the relationship between the plaintiff and the defendants too remote for direct misrepresentation claims.
• Claims for inducing breach of contract, negligence, and expert witness immunity were allowed to proceed to trial.
• The plaintiff was granted leave to amend their claim to include the tort of unlawful means, based on alleged misrepresentations to the insurer.
• Justice Kristin Muszynski emphasized that public policy supports recourse for individuals harmed by alleged manipulation of medical examination findings for financial gain.

Justice Kristin Muszynski underscored the gravity of the allegations, stating they went beyond mere challenges to expert witness neutrality.

The Ontario Superior Court recently addressed a lawsuit stemming from a motor vehicle collision, specifically concerning claims for accident benefits. The plaintiff in *Plante (Litigation Guardian) v. Dynamic Functional Solutions Inc. et al, 2026 ONSC 4502*, who was born with disabilities and required assistance for daily living, was involved in an accident on May 30, 2019. Following the collision, her needs allegedly increased, prompting her to apply for attendant care benefits in 2020 from her automobile insurer, Definity Insurance Company, under the Statutory Accident Benefits Schedule (SABS), which includes amendments effective June 1, 2016.

In accordance with section 44 of the SABS, Definity Insurance Company requested the plaintiff undergo various medical examinations to determine her eligibility for benefits. For this purpose, the insurer engaged Dynamic Functional Solutions Inc. (DFS), a medical assessment firm, to coordinate these assessments. DFS subsequently retained an occupational therapist and a psychiatrist to examine the plaintiff and prepare the necessary reports. The plaintiff's litigation guardian then initiated a claim for damages against DFS, two of its employees at the time, the occupational therapist, and the psychiatrist. The lawsuit alleged that these defendants, through their involvement with the section 44 examinations and subsequent reports, negligently and/or fraudulently conspired to conceal the true extent of the plaintiff's injuries and symptoms, as well as their causal link to the collision.

The defendants subsequently filed a motion to strike several claims without leave to amend, citing rules 21.01(1), 21.01(3), and 25.11 of the Rules of Civil Procedure. While the Ontario Superior Court affirmed its jurisdiction over the matter, emphasizing that individuals should have avenues for relief against non-insurer tortfeasors even within the SABS framework, it did grant the motion to strike direct claims for fraudulent and negligent misrepresentation. This outcome means the direct claims of *Plante v Dynamic Functional Solutions misrepresentation struck* from the plaintiff's action.

The court determined that the relationship between the plaintiff and the medical assessment firm and its professionals was too remote to sustain a direct cause of action for either fraudulent or negligent misrepresentation. However, the court did acknowledge that the plaintiff might possess a reasonable cause of action for civil fraud, fraudulent misrepresentation, or the tort of deceit if pursued directly against the insurer. This distinction highlights the court's careful consideration of the proximity required for certain tort claims.

Despite striking the direct misrepresentation claims, the court denied the remainder of the defendants' motion to strike, allowing several other significant claims to advance. Specifically, the claims for inducing breach of contract, negligence, and expert witness immunity were permitted to proceed to trial. This indicates that the court found sufficient grounds for these allegations to warrant further legal scrutiny, particularly concerning the conduct of the medical assessment firm and its retained professionals.

Furthermore, the court granted the plaintiff leave to amend her statement of claim to properly address the application of the unlawful means tort. The court explained that the existing allegations could potentially form the basis for this tort, especially if the defendants' allegedly false or negligent misrepresentations to the insurer were found to have caused harm to the plaintiff as a third party. This opens a pathway for the plaintiff to pursue claims related to the 'unlawful means tort medical assessment firm' in the context of the alleged manipulation of medical findings.

Justice Kristin Muszynski, presiding over the case, underscored the gravity of the allegations, stating they went beyond mere challenges to expert witness neutrality. She characterized them as describing "a concerted effort to manipulate findings of medical examinations for financial gain, to the detriment of a vulnerable individual." This strong judicial language highlights the court's concern regarding the integrity of medical assessments within the SABS framework and the potential for an 'Ontario SABS medical exam misrepresentation'.

Justice Muszynski further articulated a clear public policy stance, asserting that there was "no good public policy reason to cloak this type of conduct in immunity or to leave a party injured by it without recourse because of a jurisdictional gap." This ruling in *Plante v Dynamic Functional Solutions 2026 ONSC 4502* provides crucial guidance on the scope of liability for third-party medical assessors and their firms in accident benefits claims, particularly where allegations of manipulated findings are at issue, even as direct misrepresentation claims against them were deemed too remote.

Lawyers should note the Ontario Superior Court's clarification on the remoteness of direct misrepresentation claims against third-party medical assessors in SABS cases, while understanding that claims for inducing contractual breach, negligence, and unlawful means can still proceed. This ruling provides guidance on the scope of liability for medical assessment firms and their professionals in accident benefits claims, particularly where alleged manipulation of findings is involved.

Source: Original reporting via Canadian Lawyer