Category: LAT Rules

M.R. v. Aviva Insurance (16-001739)

The insurer filed a motion in advance of the LAT hearing seeking an order for unredacted clinical notes and records and OHIP summary. Adjudicator Lester declined to make an order in advance of the hearing and directed the parties to argue the motion before the hearing adjudicator.

D.R. v. Echelon Insurance (16-004276)

The claimant sought an extension of time for submissions to commission an affidavit and psychiatric report. The Tribunal was advised that the claimant’s mental health had severely declined. The insurer did not file submissions. Vice Chair Hunter granted the extension.

S.L.L. v. Certas Home and Auto Insurance Company (16-000213)

One day before the scheduled hearing, the claimant’s counsel notified the LAT and the insurer that the claimant had travelled to China for a family emergency. The hearing was adjourned to a later date, which neither the claimant nor his counsel attended. The insurer sought the dismissal of the claim as abandoned. Adjudicator Gottfried held that the claimant’s actions prevented the efficient, proportional, and timely resolution of the claim, and dismissed the matter as abandoned. No costs were awarded.

Applicant v. Wawanesa Mutual Insurance Company (16-000324)

Following the claimant’s success in entitlement to a claimed medical benefit, the insurer sought reconsideration on the basis that the LAT adjudicator should not have admitted late medical documents. Executive Chair Lamoureux held that the Tribunal maintained the discretion to admit any late materials. Further, she wrote that the insurer should have objected to the late documents upon receipt of the late documents, rather than waiting until it filed its submissions on the merits of the claimant’s case.

Applicant v. Wawanesa Mutual Insurance Company (16-000324)

Following the claimant’s success in entitlement to a claimed medical benefit, the insurer sought reconsideration on the basis that the LAT adjudicator should not have admitted late medical documents. Executive Chair Lamoureux held that the Tribunal maintained the discretion to admit any late materials. Further, she wrote that the insurer should have objected to the late documents upon receipt of the late documents, rather than waiting until it filed its submissions on the merits of the claimant’s case.

Y.S. v. The Guarantee Company of North America (17-000781)

The claimant failed to participate in the initial LAT Case Conference or the resumed Case Conference. Adjudicator Markovits dismissed the claim over the objections of the claimant’s counsel.

Amorouso v. The Co-operators General Insurance Company (17-001327)

The insurer sought direction on the release of a preliminary issue hearing decision as to whether the release would impact a looming hearing. Vice Chair Hunter determined that since the release of the preliminary decision would unlikely be before the hearing, the looming hearing was cancelled and set for rescheduling.

H.A. v. Unifund Assurance Company (16-002037)

This claim was dismissed by Adjudicator Hines after the claimant failed to make any written submissions or provide any evidence supporting his IRB claim.

Applicant v. Intact Insurance Company (16-003927)

The claimant had requested an adjournment of a hearing scheduled for July 2017 to be moved to November 2017 to allow the parties to attend a global mediation. The Case Management Officer (CMO) had denied the request. Following the denial, the claimant’s counsel also told the LAT that their expert witness would be on vacation over the dates the hearing had been scheduled. On reconsideration, EC Lamoureux granted the request for adjournment, but on the basis that the claimant’s expert would be unavailable. She considered this to be new evidence or information that, if previously known, would have affected the Tribunal’s decision.

Aviva Canada Inc. v. Taylor (2017 ONSC 2661)

The insurer sought a stay of LAT proceedings while it sought judicial review of two LAT orders denying the insurer’s request for a hearing adjournment. Justice Kiteley denied the insurer’s motion. She ruled that the insurer’s request was premature, and that the LAT proceeding should reach its conclusion before the court system became involved. She reasoned that upon receipt of the LAT’s order following the determination of the legal issue, the insurer had a right of appeal on a question of law, which included questions of fairness and natural justice.