Understanding the Legal Framework

Under Ontario’s Statutory Accident Benefits Schedule (SABS), insurers are obligated to pay for “reasonable and necessary” expenses incurred by insured individuals following a motor vehicle accident. This includes medical and rehabilitation benefits, as well as attendant care services.

Importantly, the SABS stipulates that Harmonized Sales Tax (HST) applicable to these services must be paid in addition to the approved benefit amounts. For example, the Cost of Goods and Services Guideline clarifies that if HST applies to an item under sections 15 and 16 of the SABS, it is payable by the insurer on top of the maximums set out in the benefit schedule (FSRA Guideline).

Aviva’s Alleged Non-Compliance

Despite these clear rules, reports indicate that Aviva routinely fails to comply with this requirement. Specifically, it appears that HST is often deducted from within the approved Form 1 amounts — not paid above and beyond them. This reduces the funds available for actual care and can compromise the level of service that clients receive.

We Raised the Issue — But FSRA Needs a Case File

The Injury Advocates brought this concern directly to the Financial Services Regulatory Authority of Ontario (FSRA). While FSRA acknowledged that HST should be paid above the benefit maximums, they advised that they cannot take regulatory action unless a specific file is submitted where HST was denied outside of compliance with SABS.

Unfortunately, finding one has proven extremely difficult.

Aviva has done such an effective job embedding this practice into the MVA industry that many healthcare providers and legal representatives simply accept it — or worse, are unaware it’s even improper. Providers are hesitant to raise the issue because they don’t want their clients to end up personally responsible for a disputed tax amount after settlement. Legal teams often avoid conflict to protect negotiations or client relationships. As a result, the very culture of the industry has been shaped around this silent non-compliance.

Challenges in Addressing the Issue

This situation leaves providers with little recourse. Without a documented case, FSRA’s hands are tied. Yet gathering that documentation has become nearly impossible due to how thoroughly this improper billing practice has been normalized. It’s a closed loop — one that protects insurer behavior and leaves clients and providers shortchanged.

A Call to Action

If you have a file where Aviva deducted HST from within a Form 1-approved amount instead of paying it on top as required, please contact us. Just one case could open the door for FSRA to formally investigate this practice and hold Aviva accountable.

We cannot allow insurer-driven policies to override the law — especially when they impact the care and recovery of injured Ontarians.