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  MIG Update – September 14, 2026

Causation Not Determinative in Pre-Existing Condition MIG Escape  

In this week’s edition, we review a MIG escape where both parties agreed that the Applicant had a pre-existing bipolar condition. The Tribunal considered whether an IE finding that the accident caused no new injury satisfied the legal test under s.18(2) for remaining in the MIG, or whether the Respondent must specifically address if the pre-existing condition precludes maximal medical recovery. This week’s case illustrates the legal and evidentiary consequences when a Section 44 expert focuses strictly on causation while leaving the s.18(2) test unanswered.

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Factor – Pre-existing Condition

In Margeson v. Intact Insurance Company (24-010487) Shari Margeson was involved in an accident on December 30, 2022, and sought entitlement to six Treatment Plans for physiotherapy and psychotherapy services, as well as psychological, driver reintegration, and chronic pain assessments. She sought removal from the MIG pursuant to Section 18(2), arguing that pre-existing medical conditions prevent her from achieving maximal medical recovery within the MIG’s monetary cap.

The Applicant’s Position

Margeson relied on her pre-accident diagnosis of bipolar disorder, supported by an opinion letter and extensive clinical notes from her family physician, Dr. K. Chu, which affirmed that the accident exacerbated her physical and psychological injuries and that her pre-existing mental health condition directly hindered her ability to reach MMR.

The Respondent’s Position

Intact contended there was no clear causal link between the accident and the worsening of Margeson’s mental health. It relied on a Section 44 psychological assessment by Dr. S. Talebizadeh, who concluded Margeson did not sustain an accident-related psychological injury. Furthermore, it argued that Dr. Chu’s CNRs lacked specificity regarding exactly how the pre-existing bipolar disorder impacted her capacity to achieve MMR within the MIG cap.

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The Tribunal found:

• • Margeson successfully established a Section 18(2) escape from the MIG based on pre-existing bipolar disorder.
    
  • Margeson provided documented proof of a pre-existing condition, accompanied by a compelling opinion letter from her treating physician, Dr. Chu (dated February 9, 2025). The letter explicitly confirmed that her pre-existing mental health history would impede her ability to reach MMR within the $3,500 limit, a position corroborated by years of treating clinical records.
  • Although Dr. Talebizadeh was specifically asked to opine on the applicability of s. 18(2) and the impact of pre-existing conditions on MMR, the assessor left the question entirely unanswered in the report.
  • Dr. Talebizadeh’s finding that the Applicant did not suffer a new psychological injury from the accident was insufficient. Section 18(2) focuses on whether a pre-existing condition prevents recovery within the MIG. By only focusing on causation and ignoring s. 18(2), the expert failed to address the statutory test at issue.
  • Because Intact’s expert acknowledged the existence of the pre-existing bipolar disorder but remained silent on its effect on MMR, Dr. Chu’s evidence stood uncontradicted; Margeson met her burden of proof and was removed from the MIG.

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