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.

January 30, 2017

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M.M.S. v. Wawanesa Mutual Insurance Company (16-000435)

The claimant sought costs in the amount of $1,000 for the insurer's failure to produce documents in accordance with the Case Conference Order. Adjudicator Lester awarded costs of $250, reasoning that the insurer had been disrespectful of the Tribunal's process.

January 30, 2017

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F.V. v. Wawanesa Mutual Insurance Company (16-001811)

The claimant had sustained a catastrophic impairment and sought entitlement to rehabilitation benefits funding a trip to Florida and Disney World. Adjudicator Lester held that the proposed treatment did not fall within the scope of activities set out in section 16 of the SABS, and dismissed the claim.

January 30, 2017

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B.F. v. Wawanesa Mutual Insurance Company (16-000433)

The claimant sought costs in the amount of $1,000 for the insurer's failure to produce documents in accordance with the Case Conference Order. Adjudicator Lester awarded costs of $250, reasoning that the insurer had been disrespectful of the Tribunal's process.

January 27, 2017

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P.B. v. RBC Insurance Company (16-000284)

The claimant submitted an accounting report in respect of an IRB quantum. The insurer paid $2,500.00 per section 7(5) of the SABS. The claimant sought a further amount for HST. Adjudicator Sewrattan dismissed the claim for outstanding HST. The adjudicator also dismissed the claim for costs made by the insurer, stating that cost awards are...

January 27, 2017

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M.P. v. Certas Home and Auto Insurance Company (16-000525)

As a result of the accident, the claimant suffered severe knee injuries. The claimant's wife was a personal attendant at Seniors for Seniors. She provided attendant care service to the claimant, and the claimant sought entitlement to ACBs. Adjudicator Sewrattan held that the claimant was not entitled to ACBs because the service provider was not...

January 24, 2017

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M.N.K.A. v. State Farm Mutual Automobile Insurance (16-001592)

The claimant sought entitlement to NEBs and two medical benefits. Adjudicator Bass denied all claims as not meeting the requisite test for entitlement.

January 24, 2017

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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...

January 20, 2017

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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...

January 19, 2017

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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.

January 17, 2017

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V.S. v. The Dominion of Canada General Insurance Company (17-001670)

The claimant sought entitlement to a number of medical treatment plans. The insurer asserted the claimant was governed by the MIG. The claimant raised an objection to the insurer's notice letters. However, Adjudicator S.F. Mather determined the correspondence was compliant and that a medical reason was provided. On review of the medical evidence, Adjudicator Mather...

January 17, 2017

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R.H. v. TD Insurance Meloche Monnex

The claimant sought entitlement to medical benefits and removal from the MIG. Adjudicator Leslie concluded that the insurer had not complied with section 38 of the SABS in the denial timeline, and that the insurer was therefore prohibited from taking the position that the MIG applied. One of the claimed treatment plans was awarded.

January 12, 2017

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E.S. v. Unifund Assurance Company (16-000691)

The claimant sought entitlement to further medical benefits. Adjudicator Bass concluded that no further passive therapy was reasonable and necessary, and that the claimant did not require further psychological treatment.

January 12, 2017

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Applicant v. Co-operators General Insurance Company (16-000714)

The claimant sought NEBs, medical benefits, and removal from the MIG. The adjudicator found that the claimant did not satisfy the burden of being removed from the MIG. There was a causation issue as the claimant was involved in two separate accidents and the alleged injuries from each accident were similar. NEBs were denied on...

January 9, 2017

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M.J. v. Pembridge Insurance Company (16-000583)

The claimant sought IRBs and medical marijuana. The adjudicator dismissed the IRBs claim because the claimant had refused to provide post-accident income records. The claim for medical marijuana was dismissed because the claimant did not provide a proper "medical document" supporting the need for medical marijuana. The term "medical document" is defined in the federal...

January 5, 2017

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P.L.F.R. v. Intact Insurance Company (16-000145)

As a result of the accident, the claimant suffered GCS scores in the range of 12 to below 9 and sought an order that her impairment was catastrophic. The insurer argued that the GCS scores below 9 were not caused by a brain impairment. Adjudicator Flude concluded that the SABS did not require ongoing neurologic...

December 28, 2016

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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...

December 23, 2016

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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...

December 22, 2016

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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.

December 21, 2016

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Applicant v. Aviva Insurance Company (16-000272)

The insurer sought reconsideration of the Tribunal's decision on MIG because the claimant had been removed from the MIG two years prior. The Executive Chair rescinded the adjudicator's decision regarding MIG because it was not an issue before the Tribunal in dispute.

December 19, 2016

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Aviva Canada v. S.A. (16-000409)

The insurer alleged that the claimant had made material misrepresentations, and sought repayment of IRBs. After reviewing the chronology of events, Adjudicator Bass found the claimant provided a "shifting version of the facts as a whole" that evidenced "a persistent attempt to receive benefits to which he was not entitled." Repayment of IRBs was ordered.

December 16, 2016

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V.L. v. TD Meloche Monnex (16-000308)

The claimant applied for caregiver benefits. The claimant did not reside with his parents (the alleged dependants), but rather resided approximately 900 metres away on foot and 3 kms away by car. Adjudicator Treksler awarded caregiver benefits stating the legislation was silent on the term "reside" and therefore must be interpreted on a case-by-case basis...

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Toronto, Ontario M5H 3S5

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eodonnell@tgplawyers.com

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

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

416.507.1850

eodonnell@tgplawyers.com