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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January 7, 2020

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C.C. v. Erie Mutual Insurance Company (18-010778)

The claimant sought entitlement to NEBs and ACBs. Adjudicator Boyce dismissed the claims. He held that the claimant failed to place sufficient evidence before Tribunal regarding her pre-accident activities, her post-accident activities, the changes she experienced because of the accident, and the activities she placed most importance on. Further, the evidence available suggested that the...

January 6, 2020

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M.B. v. Aviva General Insurance Company (19-000030)

The claimant sought entitlement to psychological treatment, a chronic pain program, and interest on the payment of overdue benefits. Adjudicator Boyce found that the claimant was entitled to the portion of the disputed psychological treatment plan for psychological sessions; however, with respect to the remaining elements of the disputed treatment plan, he agreed with the...

January 6, 2020

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N.V. v. Allstate Insurance Company of Canada (18-008774)

The claimant sought entitlement to further IRBs; the insurer argued that the limitation period applied. Adjudicator Boyce concluded that the limitation period applied. The denials were clear, directed towards an unsophisticated person, outlined the dispute resolution process, and provided the reasons for the denial (in particular, that the claimant had returned to work). Adjudicator Boyce...

January 6, 2020

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S.G. v. Wawanesa Mutual Insurance Company (18-001861)

The claimant sought reconsideration of the Tribunal's denial of IRBs and the cost of an accounting report. Adjudicator Parish concluded that the Tribunal had not made a significant error or law or fact such that it likely would have reached a different conclusion. Most of the arguments made by the claimant were, in essence, an...

January 3, 2020

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J.P. v. Aviva General Insurance Company (18-007398)

The claimant sought entitlement to various medical/rehabilitation benefits, interest on the payment of overdue benefits, and a special award. In this amended decision, Adjudicator Punyarthi preferred the claimant's evidence over the insurer's, finding that it persuasively demonstrated the claimant was entitled to the disputed benefits. Adjudicator Punyarthi further found that the claimant was entitled to...

January 3, 2020

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D.K. v. Certas Direct Insurance Company (18-010057)

The claimant sought entitlement to NEBs and medical/rehabilitation benefits. Adjudicator Boyce found that the claimant did not suffer a complete inability to carry on a normal life, agreeing with the findings in the insurer's examination reports; while the reports noted headaches and intermittent neck and back pain, Adjudicator Boyce found it was "a stretch to...

January 2, 2020

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S.M. v. Unica Insurance Inc. (18-010164)

The claimant sought entitlement to $6,000 per month in ACBs, $344,864 in home modifications related to an elevator and therapy room, two cost of assessments, and a special award. Adjudicator Punyarthi granted most of the claims. She held that the claimant had demonstrated difficulties with his right shoulder, using the stairs, balance issues, dressing, showering,...

December 31, 2019

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M.T. v. Intact Insurance Company (18-007131)

The claimant sought entitlement to IRBs, removal from the MIG, and entitlement to various medical benefits. Adjudicator Mazerolle found that the claimant's linger pain did not meet the definition of chronic pain because there was little indication of changes in her daily activities or reporting to the family physician. He also found that the claimant...

December 30, 2019

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W.C. v. Aviva Insurance Canada (19-000454)

The claimant sought entitlement to IRBs; the insurer argued that section 55 barred the dispute because the claimant failed to attend IEs. Adjudicator Punyarthi held that the insurer, rather than the claimant, failed to comply with section 44 by failing to make the IEs on a date, time, and location that was convenient to the...

December 27, 2019

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O.R.O. v. Aviva Insurance Canada (18-007650)

The claimant sought reconsideration of the Tribunal's denial of disputed medical benefits. Adjudicator Baker was not persuaded that there was an error in law committed by the Tribunal and that the claimant's reconsideration was a request to re-litigate the dispute.

December 20, 2019

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P.S. v. Wawanesa Mutual Insurance Company (011156)

The claimant sought removal from the MIG and entitlement to two treatment plans. Adjudicator Victor held that the claimant's injuries fell within the MIG. The evidence supported that the claimant suffered soft tissue injuries, and did not support a pre-existing shoulder injury that would prevent maximal recovery under the MIG.

December 20, 2019

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V.R. v. Aviva Insurance Company (18-002880)

The claimant sought reconsideration of the Tribunal's decision not to award various medical benefits. Adjudicator Flude rejected the request. He wrote that the reconsideration request was essentially a request that the Tribunal reverse its findings of fact and prefer the claimant's assessor over the insurer's assessor. The reconsideration request was dismissed.

December 19, 2019

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C.L. v. TD Home and Auto Insurance Company (19-002670)

The claimant sought catastrophic injuries from an ATV accident. He applied to the LAT in relation to IRBs and HK expenses, which had been denied after the claimant returned to work. The insurer argued that the claimant was barred from proceeding with the dispute due to his failure to attend IEs. Adjudicator Boyce acknowledged that...

December 18, 2019

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A.B. v. Aviva Insurance Canada (18-004653)

The claimant sought entitlement to physiotherapy and the cost of an occupational therapy assessment conducted as part of a catastrophic impairment assessment. She also argued that HST was not part of the medical benefits limits. Adjudicator Ferguson accepted that HST was payable outside of the medical benefits limits. He concluded that the occupational therapy assessments...

December 18, 2019

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O.S. v. Travelers Insurance (18-003385)

The claimant sought reconsideration of the Tribunal's decision to keep the claimant in the MIG and dismissing the claims for three medical benefits. Adjudicator Watt dismissed the reconsideration request. He held that none of the grounds of Rule 18.2 were satisfied. The Tribunal had considered all the evidence and weighed the evidence as it felt...

December 18, 2019

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S.M. v. Aviva General Insurance Company (18-003786)

The claimant sought reconsideration of the Tribunal's denial of IRBs. Adjudicator Watt dismissed the reconsideration request. He held that none of the grounds of Rule 18.2 were satisfied. The Tribunal had considered all the evidence and weighed the evidence as it felt appropriate. The reconsideration was not an opportunity to re-argue the dispute.

December 18, 2019

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K.D. v. Jevco Insurance (18-005057)

The claimant sought entitlement to NEBs and ACBs; the insurer argued that no NEBs were payable before a Disability Certificate was submitted and that no ACBs were payable before a Form 1 was submitted. Adjudicator Norris agreed with the insurer and held that no claims were payable until the requisite forms were submitted to the...

December 17, 2019

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B.C. v. Aviva Insurance Company (17-007448)

The claimant sought reconsideration of the Tribunal's refusal to remove him from the MIG. Adjudicator Norris rejected the reconsideration request. He wrote that the Tribunal had not failed to consider the OCF-3s, and had not overlooked diagnoses alleged by the claimant. Rather, the Tribunal had weighed the evidence differently and did not accept the claimants...

December 17, 2019

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W.M. v. Economical Mutual Insurance Company (18-010752)

The claimant sought to dispute various accident benefits; the insurer argued that the claimant had entered into a binding settlement. Adjudicator Watt concluded that the claimant had entered into a binding settlement. He held that the evidence was clear that the intentions of the parties was a full and final release of all benefits claimed...

December 17, 2019

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S.R. v. Aviva Insurance Canada (17-008249)

The claimant sought reconsideration of the Tribunal's decision that he was barred from pursuing his claim due to failure to attend an orthopaedic assessment. Vice Chair Marzinotto granted the reconsideration due to the failure of the insurer to note the IE assessor's regulated health profession. It was the insurer's obligation to provide that information, not...

December 16, 2019

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S.K. v. Aviva Insurance Canada (18-003544)

The claimant sought reconsideration of the Tribunal's refusal to remove her from the MIG. Adjudicator Lake rejected the reconsideration request, holding that claimant's arguments were an attempt to reargue the case and to reweigh the evidence.

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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