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.

December 21, 2022

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Traders General Insurance Company v. Rumball (2022 ONSC 7215)

Both the insurer and the claimant appealed the Tribunal's decision that the claimant was entitled to IRBs up to the 104 week mark. The insurer appealed the finding that the limitation period did not bar the IRB claim because the denial was not clear and unequivocal. The claimant appealed the finding that she was not...

December 19, 2022

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Sgambelluri v. Aviva Insurance Company (20-009937)

The claimant applied to the LAT seeking entitlement to IRBs and HK expenses. Vice Chair Johal dismissed the claims. Regarding HK expenses, the claimant did not put contemporaneous evidence before the Tribunal proving an impairment with housekeeping activities. The reports the claimant relied upon were all from three years or more post-accident, and did not...

December 6, 2022

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Shalto v. Intact Insurance Company (19-014473)

The claimant was involved in a motor vehicle accident in May 2016. She applied to the LAT seeking CAT determination under Criteria 8 and entitlement to NEBs, ACBs, and numerous medical benefits. Adjudicator Grant applied the "but for" test to the issue of causation and found that although the evidence supported some level of psychological...

December 5, 2022

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Wilmot v. Aviva Insurance Company of Canada (21-002048)

The claimant applied for accident benefits arising out of an accident. There was conflicting information regarding his employment and education. In his OCF-1 , the claimant indicated he was in school, and employed. However, his OCF-3 noted that he had not worked at least 26 of the previous 52 weeks. His OCF-3 also indicated that...

December 1, 2022

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Degazio v. Bertie and Clinton Mutual Insurance Company (21-008359)

The claimant applied for accident benefits arising out of an incident. While the claimant was sleeping in his living room, another vehicle collided with the claimant’s vehicle and struck a corner of the claimant’s home. He did not see the accident occur. The claimant alleged that he sustained psychological and emotional injuries as a result...

December 1, 2022

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Rosoli v. Aviva General Insurance (21-009076)

The claimant had previously filed a LAT Application in 2018 disputing IRBs and several treatment plans. The Application proceeded to a hearing and was dismissed. The claimant did not request a reconsideration of the decision nor did she pursue an appeal. On July 9, 2021, the claimant filed a second LAT Application disputing IRBs, the...

November 30, 2022

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McKay v. Travelers Insurance (20-008456)

The claimant brought an initial application in which the sole issue being raised was whether her injuries fell under the MIG. Adjudicator Watt found that the LAT did not have jurisdiction under the SABS to determine the issue of MIG in in the absence of any specific treatment plan(s) in dispute. Adjudicator Watt stated that...

November 30, 2022

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Nash v. Aviva General Insurance Company (2022 ONSC 6723)

The claimant appealed the Tribunal's decision that he was not entitled to IRBs. The claimant argued that the Tribunal incorrectly applied the SABS, misinterpreted the IRB sections, misapprehended the evidence, and breached natural justice. The Court dismissed the appeal, holding that there were no errors of law committed by the Tribunal. The Tribunal's decision to...

November 25, 2022

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Vaitheeswaran v. State Farm Mutual Automobile Insurance Company (2022 ONSC 6346)

The claimant appealed the Tribunal's decision regarding the quantum of ACBs awarded, and the date interest began to accrue. The claimant also sought judicial review of a FSCO decision relating to housekeeping expenses. The Court dismissed the appeal, holding that the Tribunal did not commit any legal errors in its award of ACBs. The Court...

November 24, 2022

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Basuric v. Dominion of Canada General Insurance Company (2022 ONSC 6148)

The claimant appealed the Tribunal's decision that her application for accident benefits was submitted late without reasonable excuse, and that she was barred from seeking accident benefits. The Court dismissed the appeal, holding that the appeal was on a point of mixed fact and law, and as such was not subject to appeal. The Court...

November 23, 2022

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Beaudin v. Travelers Insurance Company of Canada (2002 ONCA 806)

The insurer appealed the decision of the Divisional Court (which upheld the Tribunal's decision) that a dirt bike involved in an 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...

November 18, 2022

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Hansen v. Aviva General Insurance Company (20-012796)

The claimant was involved in an accident and was deemed to be catastrophically impaired on May 23, 2018. The claimant applied for housekeeping and home maintenance (HH) benefits provided by her son prior to her CAT determination, for the period of October 4, 2015 to August 12, 2018. This claim was denied by the insurer....

November 18, 2022

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Ruchlemer v. TD Insurance Meloche Monnex (20-005381)

The insurer raised a preliminary issue and argued that the claimant was barred from applying to the LAT for failure under s. 55 and s.44 of the SABS to cooperate with an IE assessor. Secondly, the insurer argued that the claimant did not suffer a complete inability to carry on a normal life. The claimant...

November 15, 2022

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Allo v. Licence Appeal Tribunal (2022 ONSC 6368)

The claimant appealed the Tribunal's decision denying an adjournment of a scheduled hearing. The Court dismissed the appeal, holding that the denial of the adjournment was an interlocutory step from which no appeal was permitted. The Court allowed the claimant to convert the appeal to a judicial review if proper submissions were made within 10...

November 8, 2022

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Mariyadas v. Wawanesa Mutual Insurance Company (19-011670)

The claimant applied to the LAT for entitlement to IRBs of $400 per week ongoing from the date of loss, a treatment plan for physical therapy, and a special award. The insurer agreed that the claimant met the medical test for IRBs, but disagreed on the quantum. The claimant nevertheless requested that the LAT order...

November 8, 2022

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Dominion of Canada General Insurance Company (Travelers) v Mohamed (20-004572)

The insurer applied to the LAT seeking repayment of IRBs. The claimant did not participate in the hearing. Adjudicator Shapiro found that the claimant failed to advise the insurer that she started a new employment position shortly after the accident and that she received IRBs during the period of post-accident employment. Adjudicator Shapiro found that...

November 7, 2022

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K.D. v. Certas Direct Insurance Company, (19-003270)

The claimant was injured in an accident on December 1, 2015. She applied for NEBs, and was denied on May 30, 2016. The insurer raised a preliminary issue of whether the claim was barred due to the expiry of the limitation period. Claimant’s counsel conceded that the application was filed late, on March 21, 2019,...

November 7, 2022

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Majerczyk v. Economical Mutual Insurance Company (20-004327)

The claimant applied to the LAT seeking CAT determination under criteria 7 and 8 and entitlement to post-104 IRBs, ACBs, and various medical benefits. Vice-Chair Johal found that the claimant was not catastrophically impaired and was not entitled to ACBs, assistive devices, the in-dispute psychology treatment, or occupational therapy treatment. The claimant was entitled to...

October 26, 2022

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Aviva General Insurance Company v. Catic (2022 ONSC 6000)

The insurer appealed the Tribunal's decision that it was required to pay all amounts on a treatment plan as a result of a late section 38 denial, despite the claimant not incurring the amounts. The Court agreed with the insurer and allowed the appeal. The Court held that section 38(11)(2) operates to require payment of...

October 26, 2022

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Nagarajah v. TD Insurance Company (21-009034)

The claimant signed an SDN and Release on September 6, 2012 in relation to certain accident benefits, but not the entire claim (i.e. a partial release). The claimant alleged that the settlement he entered into was not a full and final settlement. He argued that the settlement was not governed by Regulation 664 or alternatively,...

October 24, 2022

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Arab v. Unica Insurance (2022 ONSC 5761)

The claimant appealed the Tribunal's decision that he was not employed at the time of the accident, and was therefore not entitled to IRBs. The claimant had only worked 20 weeks in the past 52 weeks, and was absent from at the time of the accident, but was not formally terminated until after the accident....

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com