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.

February 15, 2022

/

tgp-admin

S.V. v. Wawanesa Insurance (18-009702 and 20-001009)

The claimant applied to the LAT for a catastrophic impairment determination due to psychological impairment, IRBs, ACBs, and various medical benefits. Adjudicator Hines concluded that the claimant did not suffer a catastrophic impairment as a result of the accident. While the claimant did sustain a psychological impairment in the accident, he sustained only Class 2...

February 15, 2022

/

tgp-admin

Samra v. Zenith Insurance Company (20-003287)

The claimant applied to the LAT disputing numerous treatment plans for therapy, assessments, and psychological treatments. The insurer raised a preliminary issue and argued that the claimant was barred from proceeding with the dispute under section 55 for failure to attend IEs to address IRBs. Vice-Chair McGee noted that the claimant had not in fact...

February 11, 2022

/

tgp-admin

DeGroot v. Licence Appeal Tribunal (2022 ONSC 6160)

The claimant appealed the Tribunal's decision awarding IRBs of $161.11 per week up to October 6, 2020, and declining to award any IRBs thereafter. The claimant also appealed the dismissal of the special award claim. The Court dismissed the appeal, holding that the Tribunal's weekly IRB award was accurate in light of the claimant's accounting...

February 9, 2022

/

tgp-admin

Fard v. Economical Insurance (19-010239)

The claimant applied to the insurer for IRBs and ACBs. The insurer paid the claimant an IRB from her initial eligibility until August 22, 2019. The insurer had arranged four IEs in July of 2019, which the claimant did not attend. The insurer rescheduled all four IEs to provide the claimant another chance to attend,...

February 8, 2022

/

tgp-admin

Teutloff v. Wawanesa Mutual Insurance Company (19-010851)

The claimant applied to the LAT for a catastrophic impairment determination due to psychological impairment. Adjudicator Grieves held that the claimant suffered from Class 4 Marked Impairments in both concentration, and adaptation, and therefor met the pre-2016 catastrophic impairment definition. The claimant suffered from Adjustment Disorder with Mixed Anxiety and Depression, and Somatic Symptom Disorder...

February 8, 2022

/

tgp-admin

Aviva Insurance Company of Canda v. Saunders (20-009069)

The insurer sought repayment of IRBs due to the claimant's return to work, which he failed to report for six months. The claimant and the insurer initial agreed to a repayment plan of $200 per month, but the claimant ceased payment eventually. The insurer sent a new repayment request for the remaining overpayment. Adjudicator Boyce...

February 7, 2022

/

tgp-admin

Zakaria v. Wawanesa Mutual Insurance Company (20-008398)

The claimant sought entitlement to NEBs and various medical benefits. The insurer raised a preliminary issue regarding the admissibility of the claimant's chronic pain assessment, which was served two months after the production date set at the Case Conference. Adjudicator Kepman found the claimant's chronic pain assessment inadmissible, as the claimant consented to the production...

February 7, 2022

/

tgp-admin

Joseph v. ACE INA Insurance (19-010124)

The claimant was involved in a motor vehicle accident in 2018. He was later determined to be catastrophically impaired as a result of the accident. The claimant applied to the LAT seeking entitlement to numerous medical and rehabilitation benefits, including the cost of cancellation fees, home modifications totaling $262,619.50, the cost of a trip to...

February 7, 2022

/

tgp-admin

Keshavarz v. Aviva General Insurance (20-001377)

The claimant sought a special award from the insurer relating to the denial and subsequent approval of a psychological assessment prior to a LAT hearing. Adjudicator Hines determined that the insurer unreasonably withheld and delayed payment of a treatment plan for the psychological assessment. As a result, she determined that a special award of 25...

February 5, 2022

/

tgp-admin

Johnson v The Dominion of Canada General Insurance Company (20-001056)

The claimant was involved in a motor vehicle accident and sought benefits pursuant to the SABS. On January 24, 2019, the claimant filed a LAT application to determine whether her injuries fell within the MIG as well as her entitlement to various treatment plans. On February 4, 2020, the claimant filed a second application which...

February 3, 2022

/

tgp-admin

Kellerman-Bernard v. Unica Insurance Inc. (20-002064)

In 2016, the claimant's child was involved in a motor vehicle accident. The claimant, who was not involved in the accident and did not witness the accident, sought accident benefits in 2016 based on alleged psychological and mental injuries as a result of her child's accident. In 2018, the claimant submitted an application for determination...

February 3, 2022

/

tgp-admin

Nehme v. Aviva General Insurance (20-006675 & 20-006677)

The claimant went grocery shopping and carried half of her groceries into her home. On the next day, the claimant proceeded to retrieve the remainder of the groceries from her car, when she slipped and fell approximately 12 to 15 feet away from her vehicle. The claimant applied for accident benefits and the insurer denied...

February 3, 2022

/

tgp-admin

Sharma v. Allstate Insurance (2022 ONSC 803)

The claimant appealed the Tribunal's decision that she was barred from disputing NEBs due to the limitation period. She missed the limitation period by five days. The Court allowed the appeal, and ordered the Tribunal to rehear the preliminary limitation defence with a new adjudicator. The Court held that the Tribunal erred in three ways....

February 2, 2022

/

tgp-admin

Ibrahim v. Economical Mutual Insurance Company (20-007384)

The claimant applied to the LAT seeking removal from the MIG, entitlement to chiropractic services, lost educational expenses, and a special award. The insurer sought repayment of $2,800 in IRBs for a period of time the claimant had returned to work and not notified the insurer. Adjudicator Hans concluded that the claimant had chronic pain...

January 31, 2022

/

tgp-admin

Pereira v. Aviva (2022 ONSC 688)

The claimant appealed the Tribunal's decision that he was not entitled to certain medical benefits because services were incurred prior to submission of a treatment plan, and that he could not add new claims for NEBs and a special award in his written submissions. The Divisional Court dismissed the appeal in its entirety. First, the...

January 28, 2022

/

tgp-admin

Gyesus v. Royal Sun Alliance (21-001119)

The claimant testified that she exited left out of a parking lot when another vehicle struck her car on the front driver's side. Both vehicles were towed from the accident scene in London to Mississauga. The police attended the scene and created a motor vehicle collision report, but did not conduct an investigation. The report...

January 26, 2022

/

tgp-admin

Oram v. Aviva General Insurance (20-006962)

The claimant exited his truck, and left the vehicle running while he walked up to a building. While returning to his vehicle, he slipped on ice and fell. The claimant applied for accident benefits and the insurer denied the application, stating that the claimant was not involved in an "accident" as defined by the SABS....

January 21, 2022

/

tgp-admin

Amminikandiyil v. Unifund Assurance Company (19-010045)

The claimant sought entitlement to IRBs. The claimant claimed that she was employed for 26 of the last 52 weeks prior to the accident, and provided six paystubs to support her claim. Adjudicator Norris found that the claimant did not meet the minimum employment threshold to qualify for IRBs, as there was no evidence to...

January 21, 2022

/

tgp-admin

J.D. v. Intact Insurance Company (19-002767)

The claimant was involved in a motor vehicle accident in 2018. As a result of the accident, his leg was amputated. His injuries were deemed catastrophic by the insurer. The claimant applied to the LAT seeking entitlement to attendant care benefits in the amount of $6,000 per month, housekeeping expenses, and numerous medical and rehabilitation...

January 21, 2022

/

tgp-admin

Racey v. The Co-operators General Insurance Company (20-011995)

The claimant parked and exited her vehicle, and proceeded to walk around the rear of the vehicle when she slipped and fell on an icy driveway. The claimant applied for accident benefits and the insurer denied the application, stating that the claimant was not involved in an "accident" as defined by the SABS. Vice-Chair Farlam...

January 19, 2022

/

tgp-admin

Mai v. Aviva Insurance Company of Canada (20-0105232)

The insurer brought a motion seeking to dismiss the application for IRBs as statute barred by section 56 of the SABS. Adjudicator Farlam held that the claimant's application was statute-barred. The insurer submitted: (1) the claimant was statute-barred from bringing its IRB claim pursuant to section 56 as the claimant commenced the application more than...

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP Disclaimer | Privacy Policy | Statement of Principles

Powered by Crow & Pitcher

Subscribe to get TGP’s case summaries straight to your inbox

Subscribe to get TGP’s case summaries straight to your inbox

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP