Category: LAT Rules

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.

S.G. v. The Personal Insurance Company (16-000338)

The claimant sought to admit an audio recording he made during an IE assessment. The insurer objected to the audio recording being entered as evidence. Adjudicator Lester relied upon the section 15 of the SPPA in establishing her authority to determine what evidence to admit at the hearing. She concluded that the audio recording was not relevant to the issues in dispute and was therefore not admitted into evidence.

A.A. v. State Farm (16-000448)

The claimant sought a waiver of the $100 LAT filing fee in accordance with the Administration of Justice Act. The LAT held that the Administration of Justice Act did not apply to Tribunals, and, even if it did, the claimant had not provided a sufficient factual basis for granting a fee waiver.