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.

April 21, 2022

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Carmel Jeffery v. Aviva Insurance Company (20-006381)

The claimant's husband passed away from accident-related injuries in 2017. The insurer paid a funeral benefit and a spousal death benefit. The claimant also applied for a death benefit as a dependent, pursuant to section 26(2)2. of the SABS. The insurer denied the death benefit based on a determination that the claimant was not principally...

April 20, 2022

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Bagla v. TD Ins. Meloche Monnex (20-004159)

A request for reconsideration of a preliminary issue decision was filed by the claimant. The preliminary issue decision found the claimant was statute barred for failure to appeal the denial of attendant care benefits in the two year limitation period. In this case, the claimant was involved in two accidents: one on March 3, 2014...

April 19, 2022

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Gichuki v TD Insurance Meloche Monnex (20-004631)

The claimant sought entitlement to attendant care benefits in the amount of $7,644.34, less $225.75 approved by the insurer, per month, from May 22, 2018 and ongoing. Vice Chair McGee found that attendant care benefits were not payable prior to October 31, 2019 when she submitted an Assessment of Attendant Care Needs (Form 1), pursuant...

April 12, 2022

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Perrigard v. Primmum Ins. Co. (19-010651)

This is a reconsideration decision. At the hearing, Vice-Chair Boyce found that the claimant was barred under section 56 of the SABS from proceeding with his application for failure to commence the application within two years of receipt of valid denials, and for his failure to attend a properly scheduled IE assessments. The claimant submitted...

April 12, 2022

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Sahadeo v. Pafco Insurance Company (19-006331)

A hearing regarding disputed medical benefits and catastrophic impairment was scheduled over eight days. The hearing was originally scheduled for July of 2021, but was rescheduled to begin on January 18, 2022. Due to a scheduling conflict, the hearing that was supposed to take place consecutively beginning January 18, 2022, was bifurcated, and the remainder...

April 11, 2022

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Wang v. Co-Operators General Insurance Company (20-009692)

The claimant applied to the LAT seeking entitlement to benefits, including a CAT assessment, after being involved in a motor vehicle accident. Vice-Chair Shapiro found that the claimant failed to establish on the evidence that a CAT assessment would be both reasonable and necessary in the circumstances, highlighting that the threshold requires the claimant to...

April 11, 2022

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Kanama v. Waterloo Insurance (19-006369)

In a prior decision, the Tribunal held that the claimant’s injuries were minor, and subject to the $3,500 MIG limit. The claimant reapplied to the tribunal, seeking an income replacement benefit and entitlement to treatment plans. The claimant asserted that his condition had worsened, and provided updated medical records. The insurer argued that the applicability...

April 7, 2022

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Hutchinson v. Aviva General Insurance Company (19-006130)

The matter had a long history of adjournments, partly due to Covid protocols and partly due to adjournment requests from the parties. During a Case Conference on October 23, 2019, the hearing was adjourned and an in-person hearing was scheduled for June of 2020. In April of 2020, the Tribunal informed the parties that the...

April 6, 2022

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Pope v. TD General Insurance Company (21-000593)

The insurer denied benefits and claimed repayment alleging that the claimant had made wilful misrepresentations. The insurer stated that the claimant, who was the driver in the subject accident, had misrepresented that a second claimant ("Dawkins") had been a passenger in his vehicle when the collision incurred. The claimant did not attend the hearing. Adjudicator...

April 5, 2022

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Robinson v. AIG Insurance (20-003795)

The claimant was involved in a serious motor vehicle accident in March 2019 and was determined to be catastrophically impaired by the insurer. She applied to the LAT seeking entitlement to ACBs and various medical/rehabilitation benefits. All issues in dispute except ACBs, a special award, and costs were withdrawn after the commencement of the hearing....

March 25, 2022

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E.J. v. Economical Insurance (20-008287)

The minor claimant was the daughter and sibling of family members involved in a serious accident. The claimant was not herself in the vehicle at the time. The claimant applied for accident benefits, but the insurer denied the application arguing that the claimant was not in an accident. Vice Chair Lake agreed that the claimant...

March 23, 2022

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Yang v Dominion of Canada General Insurance Company (20-008471)

The claimant sought entitlement to four OCF-18s for physical treatment. The claimant had been removed from the MIG for psychological reasons, but the insurer maintained its denials of the disputed physical treatment plans. The claimant argued that the treatment plan denial letters were improper and failed to mention the medical and other reasons for the...

March 21, 2022

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Nagalingam v. Economical Mut. Ins. Co. (20-006884)

A request for reconsideration was filed by the insurer regarding a decision of October 29, 2021 wherein the Tribunal ordered a re-hearing on the second day of a three day hearing after unilaterally declaring a mistrial during the proceedings. The hearing addressed IRBs, an award and interest. At the subsequent case conference , the parties...

March 17, 2022

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Imeri v. Liberty Insurance (19-008097)

The claimant sought entitlement to IRBs, ACBs, various medical benefits and assessments, and the denied portion of catastrophic impairment assessments. Vice Chair Marzinotto granted entitlement to IRBs of $400.00 per week, psychological treatment and assessment, chronic pain assessment, and once further OT assessment as part of the catastrophic impairment assessments. She dismissed the claims for...

March 17, 2022

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Shweihat v. Aviva Insurance Company of Canada (20-001897)

The Tribunal determined that the claimant was not entitled to an award under s. 10 of O. Reg 664. The claimant had argued that the insurer's denial of a treatment plan was unreasonable as it had relied on an insurer examination that was contrary to the available medical records. Vice-Chair Marzinotto found that the medical...

March 15, 2022

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Pihokker v. The Personal (20-011554)

The claimant was involved in an automobile accident, and sought certain benefits that were subsequently denied by the insurer. The claimant previously applied to the Tribunal, where Adjudicator Ferguson released his decision ("the 2019 Decision") which found that the claimant's injuries fell within the MIG. The claimant did not seek reconsideration or judicial review of...

March 15, 2022

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The Estate of [K.D.F.] v. TD General Insurance Company (20-012047)

The claimant was involved in motor vehicle accidents in 2015 and 2016. At a global mediation on September 1, 2020, the claimant and insurer came to terms regarding a settlement for both accidents. Minutes of Settlement were drafted by the mediator and circulated to the parties. The AB claim related to the 2015 accident was...

March 15, 2022

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Micanovic v. Intact Insurance (2022 ONSC 1566)

The claimant appealed a production order made by the Tribunal for him to produce personal and corporate income tax records from his housekeeping provider. The Divisional Court granted the appeal and set aside the order. The Court explained that even though the production order was interlocutory, the order was "fatally flawed" and had to be...

March 14, 2022

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Sahadeo v. Pafco Insurance Company (19-006331)

A hearing regarding disputed medical benefits and catastrophic impairment over eight days. The parties commenced the hearing on January 18, 2022. Due to scheduling conflicts, the hearing was set to continue from March 28-30, 2022. Claimant's counsel issued a summons via email to an insurance adjuster for the insurer for cross-examination. The insurer's counsel argued...

March 11, 2022

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Brenner v. TD General Insurance Company (20-006389)

The claimant applied to the LAT seeking entitlement to non-earner benefits. She sustained serious injuries in an accident in 2013, when she was 12 years old. As she was not entitled to receive NEBs until she was 16, she first applied for and began receiving NEBs on May 23, 2017, at the rate of $320...

March 8, 2022

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Aviva Canada Inc. v. McNamara (2022 ONSC 1462)

The insurer appealed the Tribunal's decision that the claimant was entitled to IRBs during a period of section 33 non-compliance. The Tribunal found that the claimant's explanation for the delay in providing records was reasonable because she thought the insurer had access to her medical records by way of signed authorization, and that she was...

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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