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.

July 4, 2022

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Maillet v. The Dominion of Canada General Insurance Company (20-011519)

The insurer brought a motion requesting that the claimant's application for IRBs be barred under s. 55(1) due to IE non-attendance. The claimant had failed to attend a post 104-week physiatry IE on four occasions. Adjudicator Mazerolle found that the Notice of Examination provided sufficient medical and other reasons for the examination under s. 44....

July 4, 2022

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O’connor v. Aviva General Insurance Company (19-006131)

The claimant brought an application seeking entitlement to IRBs from December 16, 2017 to May 2018. The date of loss was December 9, 2017. She testified that she had returned to part-time work in January 2018 and transitioned to full-time work in April or May 2018. However, the insurer identified two IE reports in which...

July 4, 2022

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Waring v Aviva General Insurance Company (21-012529)

A videoconference hearing had been arranged in relation to catastrophic impairment and attendant care. Ahead of the hearing, the claimant filed a motion to exclude a report from the insurer relating to ACBs and alleged the insurer's notice was deficient. The claimant argued that the resulting report and Form 1 should be excluded from the...

July 4, 2022

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Yevdokymova v. Economical Insurance (21-000502)

The claimant sought a catastrophic impairment designation and entitlement to various medical benefits and attendant care benefits. The insurer argued that the claimant was barred from disputing entitlement because an earlier hearing regarding NEBs already concluded that the claimant did not suffer the majority of the injuries or impairments allegedly sustained in the accident. The...

June 28, 2022

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Sahadeo v. Pafco Insurance Company (19-006331)

The claimant sought catastrophic impairment designation under Criterion 7 (53% WPI, rounded to 55%) and/or Criterion 8 (marked impairment in Adaptation) of the SABS, as well as entitlement to various medical benefits. Vice Chair Lester found that the claimant was not catastrophically impaired. With respect to Criterion 8, Vice Chair Lester felt that the claimant...

June 27, 2022

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Joslin-Mielke v Pembridge (19-012118)

The claimant applied to the LAT after a dispute regarding the appropriate quantum of ACBs. The claimant argued that due to the complexities of her injury and impaired mobility she would require emergency assistance throughout the night and when traveling within the community. The insurer had already made payment to the claimant for ACBs but...

June 27, 2022

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Ramnarine v. Aviva General Insurance (20-007108)

The claimant sought catastrophic impairment designation under Criterion 8 (marked impairment in Activities of Daily Living, Social Functioning, and Adaptation), as well as entitlement to Non Earner Benefits and various medical benefits. The claimant had a significant pre-accident medical history for chronic pain, Somatic Symptom Disorder, and Major Depressive Disorder. Adjudicator Hines found that the...

June 24, 2022

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Warren v. Licence Appeal Tribunal (2022 ONSC 3741)

The claimant appealed the Tribunal's decision that he was entitled to only $2,600 in IRBs, and that he was not entitled to a special award. His grounds of appeal were based on allegations of unfairness. First, he argued that the Tribunal's reconsideration process was procedurally unfair because it permitted the adjudicator hearing the matter at...

June 16, 2022

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Gilani v. Travelers Insurance Company of Canada (19-009248)

The claimant brought a motion to add claims for extracontractual issues, to add claims for bad faith against the adjusters personally, and to add claims against an investigation company for intrusion upon seclusion. Adjudicator Mazerolle held that the Tribunal did not have the statutory authority to adjudicate claims outside of the SABS and the accident...

June 14, 2022

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Singh v. Aviva Insurance Company (20-008014)

In this LAT dispute, the insurer challenged the length and hourly rates claimed in one of the claimant's treatment plans. The claimant was seeking $1,466.25 in remaining amounts for psychological treatment. The plan consisted of twelve one and a half hour sessions at the hourly rate of $224.42. Dr. Harris' psychological report, which formed the...

June 9, 2022

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Landa v. The Dominion of Canada General Insurance Company (19-011699)

This is a reconsideration decision. In the initial decision the LAT barred the claimant from proceeding with claims for benefits because she applied to the LAT outside of the limitation period. The LAT further determined that it lacked discretion to extend the limitation period under s. 7 of the LAT Act. The reconsideration hearing proceeded...

June 8, 2022

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Bernard v. Unica Insurance Inc. (20-007082)

The claimant sought catastrophic impairment designation, as well as entitlement to non earner benefits, attendant care benefits, and housekeeping benefits. The claimant, who had a pre-existing history of ADHD and Asperger's syndrome, suffered a comminuted fracture of his left tibia/fibula when he was struck by a car while riding his bicycle. The claimant underwent two...

June 7, 2022

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Singh v. Wawanesa Mutual Insurance Company (2022 ONSC 3361)

The claimant appealed the LAT's decision that she was not entitled to IRBs. She argued that she was denied procedural fairness by the Tribunal due to late production of raw testing data from an IE psychologist. She also argued that the insurer did not make best efforts to obtain the IE assessor's records. The Court...

June 7, 2022

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Yatar v. TD Meloche Monnex

The claimant appealed the Divisional Court's dismissal of her judicial review application, in which the Divisional Court held that judicial review of a LAT decision should only be granted in exceptional circumstances. The Court of Appeal upheld the decision dismissing the judicial review, but modified the grounds on which judicial review could be sought. The...

June 6, 2022

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Padua v. Co-operators General Insurance Company (20-005450)

The claimant brought a LAT application after various treatment plans were denied because her injuries were deemed to fall under the MIG. She also sought a special award for unreasonably withheld or delayed payments. Several months after the accident in April 2018, the claimant had voluntarily withdrawn from receiving treatment without exhausting her MIG benefits....

June 5, 2022

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R. S. v. Optimum Insurance Company (20-006166)

The claimant alleged that he was involved in an accident and injured while using and operating his vehicle to drive to an outdoor space to meditate. The claimant has a long history of mental health issues and addiction, and had previously expressed suicidal ideations. The insurer denied the claimant’s accident benefits claim, and argued that...

June 5, 2022

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C.T. v Aviva Insurance Company of Canada (20-004000)

The claimant alleged that an accident occurred as he was walking towards a transit bus. As the bus began to pull away from the bus stop, the claimant reported that he knocked on the side of the bus as it drove away. He claimed to have made momentary eye contact with the driver before losing...

June 2, 2022

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Kalk v. Intact Insurance Company (20-002839)

The claimant sought catastrophic impairment designation, as well as entitlement to attendant care benefits and housekeeping benefits. The 24 year old claimant suffered numerous fractures as a result of a head-on collision, and required multiple surgeries and nearly two months in hospitals and in-patient rehabilitation. Vice Chair Shapiro found that the claimant was catastrophically impaired...

May 31, 2022

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G.P. v. Wawanesa Mutual Insurance Company (18-010583)

The claimant applied to the LAT for a catastrophic impairment designation, post-104 week IRBs, the cost of CAT assessments, and various medical benefits. Vice Chair Lester found that the claimant suffered a catastrophic impairment due to Class 4 Marked Impairments in both adaptation, and concentration, persistence, and pace. The claimant suffered from chronic pain as...

May 30, 2022

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Islam v. Toronto Transit Commission Insurance Company (20-014052)

The claimant applied to the LAT for a catastrophic impairment designation. Vice Chair Flude concluded that the claimant did not meet the definition, as she did not have a combined physical and mental impairment exceeding 55 percent WPI , and did not suffer at least one Class 4 Marked Impairment. The claimant's assessor wrote that...

May 30, 2022

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Sambasivam v. Sonnet Insurance Company (20-014115)

The insurer brought a preliminary issue motion with the LAT to determine whether the accident alleged by the claimant had occurred. It sought a repayment of IRBs paid and costs for investigation and legal fees. The claimant alleged that he had been a passenger in a vehicle driven by the witness, his sister, when they...

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Contact Us

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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