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.

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...

March 7, 2022

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Powell v. Aviva Insurance Company of Canada (19-012928)

The claimant sought a catastrophic impairment designation, entitlement to ACBs, and medical benefits for occupational therapy and vision therapy. Adjudicator Grieves found that the claimant suffered a Class 4 Marked Impairment in adaptation, and therefore met the catastrophic impairment definition. The accident was a relatively minor rear-end collision, but resulted in the claimant suffering from...

March 6, 2022

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Sugunarajan v. Wawanesa Mutual Insurance Company (21-000665)

A hearing had been scheduled to start on July 18, 2022. Prior to the hearing, the claimant filed a Notice of Motion seeking to strike certain expert reports of the insurer from being introduced into evidence, alleging that the notices of examination did not contain sufficient medical and other reasons for the examination. Although the...

March 6, 2022

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J.T. v. Certas Home and Auto Insurance Company (19-001148)

The claimant was injured in an accident in which a bus was struck by a train, and he was found to suffer a catastrophic impairment. He applied to the LAT claiming $166,437 in home modifications, $839,104 for the cost of a new home, weekly housekeeping expenses, and a special award. The insurer sought repayment of...

March 4, 2022

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Alsaghir v. The Co-operators General Insurance Company (20-010596)

The claimant sought entitlement to accident benefits following an incident in which he parked in someone else's parking spot, and as a result he was yelled at and his vehicle was vandalized. The claimant argued that he suffered psychological injuries as a result. The insurer denied that the incident was an "accident". Adjudicator Makhamra concluded...

March 4, 2022

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Gefon v. Aviva General Insurance Company, (20-010471)

The claimant submitted a treatment plan for chiropractic treatment on June 6, 2017. The insurer denied the claimant’s treatments, as they deemed her to fall within the MIG. The insurer sent a subsequent letter to the claimant advising her of her required attendance at an insurer examination. The claimant submitted an application to the LAT...

March 2, 2022

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Luluquisin v Aviva Insurance Company of Canada (20-010381)

The claimant (who was catastrophically impaired) sought entitlement to attendant care benefits at the rate of $6,000 per month as well as various medical benefits. Adjudicator Farlam accepted the insurer's monthly attendant care rate ($1,029.42 per month) as the claimant failed to establish with medical evidence that $6,000 per month in attendant care services was...

March 1, 2022

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Aflo v. Aviva General Insurance Company (20-001404)

The claimant applied to the LAT because its insurer sought to deduct EI sickness benefits from her IRBs as "gross employment income". Vice Chair Johal found that EI sickness benefits were not deductible from an IRB. Vice Chair Johal rejected the insurer's argument that the EI sickness benefits were being received as a result of...

February 28, 2022

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Tagoe v. The Personal Insurance Company (21-001366)

A preliminary issue hearing was held to determine whether the claimant was barred from proceeding with his claim for IRBs due to failure to commence his application within two years after the insurer's refusal to pay the amount claimed. Adjudicator Corapi concluded that the claimant was statute-barred from proceeding with his application for IRBs and...

February 28, 2022

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Bablak v. Gore Mutual Insurance Company (20-002022)

The matter had previously been set down for a five-day hearing to commence on June 7, 2021. On June 7, 2021, counsel for the claimant authored an email to the LAT and the insurer's counsel stating that the claimant was withdrawing the LAT Application. The claimant did not submit a formal Notice of Withdrawal. The...

February 24, 2022

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Zhang v. The Co-Operators General Insurance Company (20-003427)

The claimant disputed entitlement to the unapproved balance of $5,912.81 for CAT assessments. The unapproved portion of the assessments represented four file review assessments and transportation costs (before the first 50 km). Adjudicator Norris held that any fee associated with reviewing files should be included in the $2,000 assessment fee. He further held that as...

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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