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.

February 7, 2022

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Zakaria v. Wawanesa Mutual Insurance Company (20-008398)

The claimant sought entitlement to NEBs and various medical benefits. The insurer raised a preliminary issue regarding the admissibility of the claimant's chronic pain assessment, which was served two months after the production date set at the Case Conference. Adjudicator Kepman found the claimant's chronic pain assessment inadmissible, as the claimant consented to the production...

February 7, 2022

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Joseph v. ACE INA Insurance (19-010124)

The claimant was involved in a motor vehicle accident in 2018. He was later determined to be catastrophically impaired as a result of the accident. The claimant applied to the LAT seeking entitlement to numerous medical and rehabilitation benefits, including the cost of cancellation fees, home modifications totaling $262,619.50, the cost of a trip to...

February 7, 2022

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Keshavarz v. Aviva General Insurance (20-001377)

The claimant sought a special award from the insurer relating to the denial and subsequent approval of a psychological assessment prior to a LAT hearing. Adjudicator Hines determined that the insurer unreasonably withheld and delayed payment of a treatment plan for the psychological assessment. As a result, she determined that a special award of 25...

February 5, 2022

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Johnson v The Dominion of Canada General Insurance Company (20-001056)

The claimant was involved in a motor vehicle accident and sought benefits pursuant to the SABS. On January 24, 2019, the claimant filed a LAT application to determine whether her injuries fell within the MIG as well as her entitlement to various treatment plans. On February 4, 2020, the claimant filed a second application which...

February 3, 2022

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Kellerman-Bernard v. Unica Insurance Inc. (20-002064)

In 2016, the claimant's child was involved in a motor vehicle accident. The claimant, who was not involved in the accident and did not witness the accident, sought accident benefits in 2016 based on alleged psychological and mental injuries as a result of her child's accident. In 2018, the claimant submitted an application for determination...

February 3, 2022

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Nehme v. Aviva General Insurance (20-006675 & 20-006677)

The claimant went grocery shopping and carried half of her groceries into her home. On the next day, the claimant proceeded to retrieve the remainder of the groceries from her car, when she slipped and fell approximately 12 to 15 feet away from her vehicle. The claimant applied for accident benefits and the insurer denied...

February 3, 2022

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Sharma v. Allstate Insurance (2022 ONSC 803)

The claimant appealed the Tribunal's decision that she was barred from disputing NEBs due to the limitation period. She missed the limitation period by five days. The Court allowed the appeal, and ordered the Tribunal to rehear the preliminary limitation defence with a new adjudicator. The Court held that the Tribunal erred in three ways....

February 2, 2022

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Ibrahim v. Economical Mutual Insurance Company (20-007384)

The claimant applied to the LAT seeking removal from the MIG, entitlement to chiropractic services, lost educational expenses, and a special award. The insurer sought repayment of $2,800 in IRBs for a period of time the claimant had returned to work and not notified the insurer. Adjudicator Hans concluded that the claimant had chronic pain...

January 31, 2022

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Pereira v. Aviva (2022 ONSC 688)

The claimant appealed the Tribunal's decision that he was not entitled to certain medical benefits because services were incurred prior to submission of a treatment plan, and that he could not add new claims for NEBs and a special award in his written submissions. The Divisional Court dismissed the appeal in its entirety. First, the...

January 28, 2022

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Gyesus v. Royal Sun Alliance (21-001119)

The claimant testified that she exited left out of a parking lot when another vehicle struck her car on the front driver's side. Both vehicles were towed from the accident scene in London to Mississauga. The police attended the scene and created a motor vehicle collision report, but did not conduct an investigation. The report...

January 26, 2022

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Oram v. Aviva General Insurance (20-006962)

The claimant exited his truck, and left the vehicle running while he walked up to a building. While returning to his vehicle, he slipped on ice and fell. The claimant applied for accident benefits and the insurer denied the application, stating that the claimant was not involved in an "accident" as defined by the SABS....

January 21, 2022

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Amminikandiyil v. Unifund Assurance Company (19-010045)

The claimant sought entitlement to IRBs. The claimant claimed that she was employed for 26 of the last 52 weeks prior to the accident, and provided six paystubs to support her claim. Adjudicator Norris found that the claimant did not meet the minimum employment threshold to qualify for IRBs, as there was no evidence to...

January 21, 2022

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J.D. v. Intact Insurance Company (19-002767)

The claimant was involved in a motor vehicle accident in 2018. As a result of the accident, his leg was amputated. His injuries were deemed catastrophic by the insurer. The claimant applied to the LAT seeking entitlement to attendant care benefits in the amount of $6,000 per month, housekeeping expenses, and numerous medical and rehabilitation...

January 21, 2022

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Racey v. The Co-operators General Insurance Company (20-011995)

The claimant parked and exited her vehicle, and proceeded to walk around the rear of the vehicle when she slipped and fell on an icy driveway. The claimant applied for accident benefits and the insurer denied the application, stating that the claimant was not involved in an "accident" as defined by the SABS. Vice-Chair Farlam...

January 19, 2022

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Mai v. Aviva Insurance Company of Canada (20-0105232)

The insurer brought a motion seeking to dismiss the application for IRBs as statute barred by section 56 of the SABS. Adjudicator Farlam held that the claimant's application was statute-barred. The insurer submitted: (1) the claimant was statute-barred from bringing its IRB claim pursuant to section 56 as the claimant commenced the application more than...

January 19, 2022

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Jarret v. Aviva Insurance Company of Canada (20-007746)

The claimant filed a motion seeking to add punitive damages as an additional issue in dispute to the LAT application. The insurer argued that the Tribunal had determined on numerous occasions that it did not have the power to order punitive damages. After considering the legislation, Adjudicator Mazerolle agreed with the insurer that it was...

January 19, 2022

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Hagopian v. Allstate Insurance (20-000998)

The claimant was the driver of an all-terrain vehicle which collided with a dirt bike on private property. Neither vehicle was insured and the claimant suffered a severe brain injury as a result of the collision. The issue in dispute is whether either vehicle would be defined as an automobile pursuant to the Insurance Act....

January 14, 2022

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F.T. v. The Co-Operators Insurance Company (19-001291)

The self-employed claimant applied to the LAT seeking entitlement to medical benefits outside of the MIG and a determination of the quantum of IRBs. The insurer had paid IRBs in the amount of $59 per week, based on its expert accounting report. The claimant sought IRBs in the amount of $400 per week, based on...

January 13, 2022

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Pafco Insurance Company v. Sahadeo (2022 ONSC 328)

The insurer appealed the Tribunal's preliminary order excluding surveillance at an upcoming hearing. Justice Corbett dismissed the appeal, holding that it was premature and an abuse of process. If the insurer is ultimately unsuccessful at the hearing and if it decides to appeal, it will be open to the insurer to raise the issue of...

January 11, 2022

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McCormick v. Allstate Canada (21-001362)

The claimant failed to attend four separate IEs arranged by the insurer to address post-104 IRBs. The insurer filed a Notice of Motion requesting that the claimant's application be dismissed. The insurer argued that insufficient medical evidence had been provided by the claimant, and an independent medical opinion was needed in order to properly address...

January 11, 2022

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Mosa v. BelairDirect Insurance Company (21-011987)

The claimant brought a motion to: (1) compel the insurer to provide particulars clarifying a statement made by a claims representative in an email regarding a job site analysis; and (2) excluding the claims representative from representing the insurer before the Tribunal. Vice Chair Maedel dismissed both motions. Whether the claims representative stated something different...

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Contact Us

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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