Category: LAT Rules

M.Y.Y. v. Dominion of Canada General Insurance Company (16-002636)

The accident involved two people, each with claims. The insurer requested that the matter be combined. The claimants did not consent. The two hearings shared only one common witness. Vice Chair Trojek denied the request for the combination of hearings. Under Rule 20.5 Vice Chair Trojek did not find any value in terms of “fairness, efficacy, or cost effectiveness” in having the matters combined. Privacy rights were also cited.

T.D. v. The Dominion of Canada General Insurance Company (16-002640)

The claimant sought to combine the hearing of his case with the hearing of another applicant’s claim, as both claims arose from the same accident. The insurer opposed combining the files. Adjudicator Trojek denied the request to combine the hearings, reasoning that the claims dealt with two different claims by two difference people. Each claim was unique, and there was no value in terms of fairness, efficacy, or cost in having the matters heard together.

Applicant v. Unifund Assurance Company (16-000879)

The claimant sought an order for NEBs, and medical benefits. As a preliminary issue, the insurer sought the exclusion of documents not produced in accordance with the Case Conference Order. Adjudicator Truong held that the Tribunal could set deadlines that were more stringent than those in the LAT Rules. The documents were excluded and the claims for NEBs and medical benefits were dismissed.

C.S.Z. v. Allstate Insurance Company of Canada (16-000270)

The claimant sought IRBs in the amount of $400 per week. Adjudicator Marzinotto allowed the admission of surveillance evidence. She also allowed the admission of a report without an Acknowledgement of Expert’s Duty. In terms of the benefits in dispute, the adjudicator denied the claim for IRBs, stating that the claimant had not proved his entitlement and had not provided information that would allow the Tribunal to calculate the weekly quantum.

M.B. v. Dominion of Canada General Insurance (16-001825)

The claimant’s application was dismissed due to his failure to participate in the Case Conference.

T.S. v. Allstate Insurance Company of Canada (16-001916)

The claimant sought entitlement to a number of medical benefits. Additionally, the claimant sought entitlement to medical benefits generally, in the sum of $10,000,000.00. The insurer resisted the claims and asserted the matter was dealt with at FSCO. The insurer raised a preliminary issue to that effect, to which the claimant was not prepared for given confusing correspondence with the LAT. As a result, the claimant sought an adjournment. Adjudicator Chloe Lester granted the adjournment.

A.B. v. Aviva Insurance Company of Canada (16-000342)

The claimant sought entitlement to NEBs and transportation costs. The insurer relied upon surveillance as part of its defence. Adjudicator Richards concluded that the claimant did not meet the complete inability test, and was not entitled to transportation costs. The adjudicator allowed the surveillance to be admitted despite non-compliance with the timelines in the LAT Rules.

Applicant v. The Personal Insurance Company (16-000338)

The claimant sought reconsideration regarding the exclusion of audio evidence obtained by the claimant during an IE. The Executive Chair held that the adjudicator had not acted outside his jurisdiction or violated the rules of natural justice or procedural fairness. The request was denied.

N.P.M.T. v. State Farm Insurance Company (16-002709)

The claimant withdrew the LAT application at the Case Conference. The insurer objected and sought costs. Adjudicator Treksler stated that the mere withdrawal of an application will “rarely, if ever, be a sufficient basis on which the Tribunal will make a costs order.” The claimant’s application and subsequent withdrawal did not rise to the level required in Rule 19.1 to warrant costs.

J.B. v. Meloche Monnex Financial Services Inc. (16-000766)

The claimant sought entitlement to three medical benefits. As a preliminary issue, the insurer sought exclusion of the claimant’s submissions due to late filing. Adjudicator Treksler held that a large and liberal interpretation of Rule 3.1 allowed the late filing of submissions in this case. The adjudicator found the disputed treatment plans reasonable and necessary.