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 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...

February 23, 2022

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Huang v. The Dominion of Canada General Insurance Company (19-006264)

The self-employed claimant sought entitlement to IRBs in the amount of $400.00 per week. The sole issue in dispute related to calculating the claimant's quantum of IRB, as the insurer calculated the claimant's IRB quantum at $0 per week. Adjudicator Kepman agreed with the insurer, and held that personal income tax returns and payroll summaries...

February 23, 2022

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Fehr v. Intact Ins. Co. (21-003866)

The claimant was involved in an incident where he fell off the roof of a transport truck and sustained a traumatic brain injury. The claimant placed a ladder against the side of the transport truck to inspect its roof. While conducting his inspection, the ladder slid out from under him. The claimant attempted to grab...

February 23, 2022

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Alazab v. Aviva General Insurance (19-011494)

A preliminary issue hearing was held where Adjudicator Norris determined that the claimant was barred from proceeding under the doctrine of res judicata. The Tribunal had previously determined that the claimant's injuries had not been caused or exacerbated by the accident. The claimant argued that her second application was for now for entitlement to NEBs...

February 22, 2022

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Maycid v. TD General Insurance Company (20-012985)

The claimant was involved in an accident in Quebec. He submitted his OCF-1 to the insurer, and elected under section 59 to receive SAAQ benefits. A disagreement arose between the claimant and the insurer as to the SAAQ benefits the claimant was entitled to. The claimant applied to the LAT. The insurer argued that the...

February 17, 2022

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Kunaseelan v. Aviva Insurance Company of Canada (20-000565)

The claimant sought entitlement to IRBs of $400.00 per week for the five month period between the date of loss and the date the OCF-3 was submitted. Adjudicator Norris dismissed the claim, holding that section 36(3) barred the claimant's entitlement to IRBs for the period prior to OCF-3 submission. The claimant argued that the insurer...

February 17, 2022

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Harvey v. Economical Insurance Company (19-006159)

The claimant applied to the LAT seeking entitlement to various medical and rehabilitation benefits and a special award. In addition, the claimant brought a motion seeking to exclude the insurer’s submission of surveillance and the transcript from the claimant’s EUO. The claimant submitted that the insurer conducted surveillance prior to the EUO, which demonstrated that...

February 17, 2022

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Amorim v. Jevco Insurance (19-012408)

The claimant applied to the LAT seeking entitlement to attendant care benefits in the amount of $7,522.85 per month. The claimant was involved in a serious motor vehicle accident in 2012. In 2017, the insurer determined that the claimant was catastrophically impaired as a result of psychological impairments. The disputed attendant care services included feeding,...

February 15, 2022

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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

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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

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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

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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

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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...

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com