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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April 28, 2020

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D.G. v. RSA Insurance Company (19-004884)

The claimant sought entitlement to ACBs and HK expenses. The insurer argued that the claimant was barred from contesting the denials as she filed her application over two years after the benefits were denied. Adjudicator Mazerolle ruled that the claimant was allowed to proceed with her claim in accordance with Tomec v. Economical. He noted...

April 28, 2020

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T.S. v Aviva Insurance Canada (18-002858)

The claimant sought entitlement to IRBs which had been terminated, a special award, costs, and interest. The claimant argued that the insurer did not take into account all of his pre-accident employment in calculating his weekly IRB, and that the insurer failed to respond to his IRB application within 10 days and therefore should be...

April 27, 2020

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L.D. v. Gore Mutual Insurance Company (18-011978)

The claimant sought reconsideration of the Tribunal's Case Conference order that a preliminary issue hearing take place to address the IE non-attendance issue, and of the Case Conference adjudicator's refusal to "strike" the issue, arguing that the adjudicator was biased. Vice Chair Jovanovich dismissed the reconsideration request because it was not a final order. Rather,...

April 27, 2020

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J.T. v. Cayuga Mutual Insurance Co.(18-006061)

The claimant sought entitlement to various medical benefits and the cost of an OCF-3. Prior to the hearing, the insurer approved the denied medical benefits, leaving only two issues remaining: a special award, and payment of an OCF-3. The claimant argued that the insurer acted unreasonably by requiring her to attend IEs prior to her...

April 27, 2020

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C.C. v Aviva Insurance Canada (19-003244)

This preliminary issue hearing was brought to determine whether the claimant was barred from seeking a determination that the injuries sustained in the accident were not subject to the MIG, as that issue had already been determined by the FSCO. Adjudicator Watt found that the claimant was barred from seeking a determination that her injuries...

April 27, 2020

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L.D. v. Gore Mutual Insurance Company (18-011978)

The claimant sought reconsideration of the Tribunal's Case Conference order that a preliminary issue hearing take place to address the IE non-attendance issue, and of the Case Conference adjudicator's refusal to "strike" the issue, arguing that the adjudicator was biased. Vice Chair Jovanovich dismissed the reconsideration request because it was not a final order. Rather,...

April 24, 2020

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C.Z. v Security National Insurance Company (18-012296)

The claimant sought entitlement to IRBs, removal from the MIG, and entitlement to a psychological assessment. Adjudicator Johal concluded that the claimant was not entitled to either IRBs or removal from the MIG. The claimant failed to provided any evidence to support his submissions that he suffers a substantial inability to perform the essential tasks...

April 24, 2020

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D.S. v Economical Insurance Company (19-004414)

The claimant was involved in an accident in Quebec and elected to receive SABS in accordance with the SAAQ system. The insurer paid a lump sum in accordance with the SAAQ. The claimant disputed the lump sum, but the insurer argued that the limitation period applied. Adjudicator Grant concluded that the dispute was barred by...

April 24, 2020

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M.G. v. Intact Insurance Company (17-008078)

The claimant sought entitlement to the cost of an accounting report related to IRBs. Adjudicator Parish dismissed the dispute. She found that the delays which occurred with the file while the insurer was conducting an investigation regarding the accident did not establish that the accounting report was reasonable and necessary. Further, she found that the...

April 24, 2020

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M.G. v. Intact Insurance Company (17-008078)

The claimant sought entitlement to the cost of an accounting report related to IRBs. Adjudicator Parish dismissed the dispute. She found that the delays which occurred with the file while the insurer was conducting an investigation regarding the accident did not establish that the accounting report was reasonable and necessary. Further, she found that the...

April 23, 2020

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U.Y. v. TD Insurance Meloche Monnex (18-002397)

The claimant filed a request for reconsideration arising from a decision in which the Tribunal found that her application for IRBs and housekeeping and home maintenance benefits were statute-barred as a result of the two-year limitation period. Adjudicator Maedel dismissed the request for reconsideration on the grounds that the claimant received a valid denial of...

April 23, 2020

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U.Y. v. TD Insurance Meloche Monnex (18-002397)

The claimant filed a request for reconsideration arising from a decision in which the Tribunal found that her application for IRBs and housekeeping and home maintenance benefits were statute-barred as a result of the two-year limitation period. Adjudicator Maedel dismissed the request for reconsideration on the grounds that the claimant received a valid denial of...

April 22, 2020

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Y.M. v Security National Insurance Company (19-001141)

The claimant sought removal from the MIG, and entitlement to various medical benefits. The insurer argued that the claimant was barred from disputing the claimed benefits due to the limitation period and due to failure to attend an IE. Adjudicator Grant agreed that two of the disputed medical benefits were barred by the limitation period,...

April 22, 2020

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J.J.X. v. Aviva General Insurance (19-002558)

The claimant sought a determination that his injuries were outside of the MIG, and entitlement to medical benefits proposed in three physiotherapy treatment plans, a chiropractic treatment plan, and a psychological assessment. The claimant also sought entitlement to non-earner benefits. Adjudicator Grant found that the claimant's injuries were predominantly minor and fell within the MIG....

April 22, 2020

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M.D. v. Aviva General Insurance (18-006666)

The claimant sought entitlement to two treatment plans, the costs of two examinations, and a special award, as well as a determination as to the quantum of an approved income replacement benefit. Adjudicator Boyce accepted the claimant's submission that she was entitled to an IRB in the amount of $297.88 per week, finding the calculation...

April 20, 2020

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S.S.Z. v. Certas Direct Insurance Company (18-007365)

The claimant filed a request for reconsideration arising from a decision in which the Tribunal found that his injuries fell within the MIG. Adjudicator Kaur first addressed the insurer's motion to exclude certain documents and submissions that were included in the claimant's request for reconsideration. Adjudicator Kaur granted the insurer's motion. She found that the...

April 17, 2020

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K.P. v. Aviva General Insurance (19-004361)

The claimant was injured while walking down the driveway to get into a Lyft, which was waiting to take her to a medical appointment. She applied for accident benefits. The insurer denied the claim, stating that the incident was not an accident. Adjudicator Mather concluded that the incident was an accident under the SABS. She...

April 17, 2020

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N.K. v. Intact Insurance Company (19-003405)

The claimant sought entitlement to the costs of examinations in two treatment plans that were performed as part of catastrophic impairment assessments. Adjudicator Norris found that although a psychiatric assessment was performed instead of an approved psychological assessment, the psychiatric assessment was reasonable and necessary in light of the claimant's post-concussion mental condition. The claimant...

April 17, 2020

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H.H. v. Aviva General Insurance (17-005287)

The claimant sought entitlement to non-earner benefits and an award. Adjudicator Gosio found that the claimant had not met her onus of establishing that she suffered a complete inability to carry on a normal life and was therefore not entitled to non-earner benefits or an award. He found that although the claimant demonstrated there were...

April 17, 2020

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M.G. v. Aviva Insurance Canada (18-002508)

The insurer sought reconsideration of the Tribunal's award of the cost of various catastrophic impairment assessments. The insurer argued that because the treatment plans were proposed after the OCF-19 was submitted, the assessments were not being proposed in accordance with section 45, and therefore not payable. Adjudicator Johal rejected the reconsideration. She held that catastrophic...

April 17, 2020

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M.G. v. Aviva Insurance Canada (18-002508)

The insurer sought reconsideration of the Tribunal's award of the cost of various catastrophic impairment assessments. The insurer argued that because the treatment plans were proposed after the OCF-19 was submitted, the assessments were not being proposed in accordance with section 45, and therefore not payable. Adjudicator Johal rejected the reconsideration. She held that catastrophic...

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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