LAT Case Law Summaries

Thomas Gold Pettingill LLP is pleased to provide this online resource to our clients. Below is a searchable database of the publicly released decisions from the Licence Appeal Tribunal. Assembled by the accident benefits group, the decisions are reviewed, briefly summarized, and categorized for easy access.

As of March 2020, we will not include any further decisions focused solely on the Minor Injury Guideline or treatment plans, unless the case may have broader applicability.

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March 26, 2021

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Cura v. Aviva Insurance Canada (2021 ONSC 2290)

The claimant sought judicial review of the Tribunal's decision that her withdrawal of consent for the IE facility to possess her personal information amounted to IE non-attendance. The claimant's reconsideration request had been dismissed as pre-mature. The Divisional Court dismissed the review, holding that it was premature. Parties are not to appeal or seek judicial...

February 26, 2021

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Beaudin v. Travelers Insurance Company of Canada (2021 ONSC 1389)

The insurer appealed the Tribunal's decision that the dirt bike involved in the accident was an automobile for the purposes of the SABS. The Tribunal had concluded that the dirt bike was required to be insured under the Off-Road Vehicles Act and was not exempt from insurance through the regulation that allowed off-road vehicles to...

December 10, 2020

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Higashi v. Western Assurance Company (2020 ONSC 7616)

The claimant appealed the Tribunal's decision that her claim for IRBs was barred by the limitation period. She argued that the insurer's denials were invalid because the insurer did not provide copies of the IE reports to the practitioners who completed the Disability Certificates. The Court agreed with the Tribunal that the insurer's failure to...

October 22, 2020

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The Personal Insurance Co. v. Jia (2020 ONSC 6361)

The insurer appealed the LAT's decision that counsel acting in a priority matter could not also act in the LAT dispute, and the decision excluding the transcript from the priority EUO from the LAT hearing. The Court dismissed the appeal and concluded that the LAT's decision was reasonable. It held that a conflict could arise...

September 28, 2020

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B.M. v. Unica Insurance Inc. (19-009381)

The claimant sought entitlement to two medical benefits for physiotherapy and occupational therapy services. The claimant had a significant pre-accident medical history that included a workplace accident, two separate motor vehicle accidents in 2013, chronic lumbar radiculopathy, and chronic lower back pain. He was also involved in a subsequent motor vehicle accident in 2016 after...

September 28, 2020

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P.S. v. Allstate Insurance (18-012633)

The claimant was seriously injured in a 2013 accident and sought a determination that he suffered a catastrophic impairment due to a combined WPI of 55 percent. He also sought entitlement to three treatment plans for further physiotherapy and psychotherapy. The claimant suffered from chronic pain and abused opioids as a result of his injuries....

September 24, 2020

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Marca v. Aviva Insurance Company (19-004839)

The claimant sought entitlement to NEBs, a medical benefit for physiotherapy services, interest on overdue payment of benefits, and an award. The claimant argued that she had partially resumed some activities post-accident but not at all. The claimant also argued that even though she had returned partially to her personal care, she experienced pain when...

September 23, 2020

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C.N. v. Aviva General Insurance (19-004405)

The retired claimant sought entitlement to NEB. He argued that the accident had exacerbated a previously asymptomatic right shoulder injury. He claimed due to the accident he suffered neck, right shoulder and lumbar spine pain that affected his ability to engage in his activities of daily living. However, he did not make any submissions on...

September 23, 2020

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M.R. v. Allstate Insurance Company of Canada (18-012729)

The claimant was involved in multiple accidents between 1991 and 2003. A preliminary hearing was held in relation to benefits claimed following a September 1996 accident and whether certain disputed benefits were captured by various releases signed by the claimant. The claimant sought entitlement to ACBs, HK expenses, transportation expenses, and home modifications. In addition...

September 22, 2020

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C.K.D. v. Wawanesa Mutual Insurance (18-006988)

The claimant slipped and fell in the process of getting into his vehicle at a gas station. The insurer argued that the incident did not qualify as an accident. Adjudicator Makhamra concluded that the incident qualified as an accident. The claimant was just next to his driver's door and was reaching out with his left...

September 18, 2020

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P.M. v. Aviva General Insurance (19-002717)

The claimant sought removal from the MIG and entitlement to medical benefits for physiotherapy, massage therapy as well as the cost of psychological and physiatry assessments, and completion of an OCF-3. The claimant also sought a special award. Adjudicator Lake found the claimant's injuries were outside of the MIG due to her chronic pain, but...

September 18, 2020

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P.B. v. The Co-operators Insurance Company (19-008343)

The claimant was receiving IRBs of $400 per week. She settled her action against her LTD provider. The LTD release indicated that it covered all claims being made against the LTD provider, including punitive damages and costs. The insurer argued that it was entitled to deduct from IRBs the amounts received from the LTD settlement....

September 17, 2020

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C.J. v. Aviva Insurance Canada (18-007905)

The claimant sought entitlement to NEBs. The claimant submitted that virtually all her activities of daily living were affected by the accident. She was unable to perform her self care, cultural homemaking activities, socialize, or go to the gym, causing her weight gain and affecting her ability to have a child - all contributing to...

September 14, 2020

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J.C. v. Aviva General Insurance Company (19-004734)

The claimant sought entitlement to various medical benefits, including medical cannabis, physical treatment, and a chronic pain program. The insurer argued that the claimant could not dispute two of the treatment plans due to IE non-attendance. The claimant responded that it wasn't reasonable to request a psychiatric assessment for the medical cannabis. Adjudicator Johal found...

September 8, 2020

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S.A. v. Aviva Insurance Canada (18-004334)

The claimant sought entitlement to IRBs in the amount of $195.81 per week, the cost of an IRB calculation report, interest and a special award. The claimant submitted that from March 9, 2016 to April 30, 2016, he suffered a substantial inability to perform the essential tasks of his pre-accident employment as a floor installer...

September 2, 2020

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Y.G. v. TD General Insurance Company (18-012431)

The claimant sought entitlement to the cost of psychological and orthopaedic assessments. The insurer argued that the disputes were barred by the limitation period. The insurer denied the claimed assessments by letter dated March 1, 2016 due to insufficient medical documentation to support injuries outside of the MIG. The letter also advised the claimant that...

September 2, 2020

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M.C. and M.C. v. Pembridge Insurance Company (18-006473 and 18-006682)

The husband and wife claimants were involved in a motorcycle accident and required amputation of their right legs. Both claimants were entitled to catastrophic impairment level benefits. Because the cost of both the claimant's and insurer's plan outpaced the cost of building a new home, neither plan was carried out. Instead, a new home was...

August 31, 2020

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G.R. v. Aviva General Insurance Company (18-004375)

Both the claimant and the insurer sought reconsideration of the Tribunal's decision awarding seven medical benefits, denying attendant care expenses, and granting a special award on a functional impairment assessment, which had been deemed incurred. The claimant argued that ACBs should have been awarded and should have been deemed incurred under section 3(8). Adjudicator Mazerolle...

August 28, 2020

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S.S. v. The Personal Insurance Company (19-004026)

The claimant sought entitlement to IRBs and removal from the MIG. Adjudicator Lake concluded that the claimant was not entitled to IRBs, but that his injuries fell outside of the MIG. With regard to IRBs, the claimant failed to prove that he was substantially unable to perform the essential tasks of his pre-accident employment. A...

August 27, 2020

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L.A. v. Wawanesa Mutual Insurance Company (19-007357)

The claimant sought entitlement to IRBs. While he was unemployed at the time of the accident, he argued that he was receiving EI benefits. The insurer argued that the claimant's EI benefits had expired one week before the accident and he was therefore not entitled to IRBs. Adjudicator Johal agreed with the insurer. The claimant...

August 26, 2020

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J.T. v. Primmum Insurance Company (18-009043)

The self-represented claimant argued that he suffered a catastrophic impairment following a collision in a parking lot. The insurer's position was that the claimant suffered a minor injury. Adjudicator Manigat concluded that the claimant suffered a minor injury and dismissed the catastrophic impairment determination. No medical evidence was provided by the claimant in support of...

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Contact Us

150 York Street, Suite 1800
Toronto, Ontario M5H 3S5

416.507.1850

smilne@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP