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.

November 5, 2021

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Amrok v. Economic Insurance Company (20-007816)

The claimant was the victim of a physical assault after he had cut off a truck on the highway. The Tribunal found that this incident did not fall within the definition of an accident under the SABS as the claimant had failed to satisfy both the purpose and causation test. The vehicle was not responsible...

November 5, 2021

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Morris v. Aviva General Insurance (19-002717)

The insurer filed a request for reconsideration after the Tribunal previously decided that, among other things, the claimant was entitled to two OCF-18s, plus interest as a result of the insurer's failure to comply with section 38 of the SABS. The insurer argued that the Tribunal had referred to case law not submitted by either...

November 4, 2021

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Boileau v. Aviva Gen. Ins. Co. (20-005804)

The preliminary issue in this matter is whether the claimant was barred from proceeding with his claims because he failed to comply with s. 44 of the Schedule by not attending properly scheduled IEs. The claimant argued that the insurer arranging IEs to address whether the claims were reasonable and necessary was inconsistent with the...

November 2, 2021

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Allen v. Certas Home and Auto Insurance Company (19-014152)

The claimant applied to the LAT disputing her entitlement to NEBs. The insurer raised a preliminary motion arguing that the claimant's dispute was barred by the limitation period, as it was commenced two years after a valid denial. Adjudicator Flude agreed with the insurer and dismissed the claim. The insurer denied the claimant's NEBs on...

October 29, 2021

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Smektala v. TD Insurance Meloche Monnex (20-006086)

The claimant applied for accident benefits following an accident while she was in the course of her employment as a personal support worker. The insurer argued that the claimant was not entitled to claim IRBs because she had elected to receive WSIB. Adjudicator Lake agreed with the insurer, holding that the claimant was not entitled...

October 29, 2021

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Mohamed v. Aviva Insurance Company (2021 ONSC 7175)

The claimant appealed the Tribunal's decision that the limitation period barred her claim for IRBs. The Court dismissed the appeal as the Tribunal did not commit an error of law. The Tribunal applied the correct legal test for determining whether the insurer's denial was sufficient. The Tribunal also exercised it discretion not to extend the...

October 27, 2021

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Sonnet Insurance Company v. Mitchell (20-006073)

The insurer alleged that the claimant made material misrepresentations about her involvement in an accident. On receipt of the medical records and after an EUO, the insurer determined the claimant was not involved in a motor vehicle accident, but had sustained injuries as a result of a fall down a flight of concrete stairs while...

October 26, 2021

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Belanger v. Intact Insurance Company (19-013755)

The insurer argued that the claimant was precluded from proceeding to a hearing on the basis that the claimant's dispute was statute barred pursuant to s. 55 of the Schedule. Adjudicator Manigat concluded that the claimant's application for IRBs could proceed and that it was not statute barred. A denial of a benefit by an...

October 25, 2021

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Parker v. Aviva Gen. Ins. Co (19-010703)

The claim arose out of a dispute as to the appropriate quantum for IRBs. Prior to the accident, the claimant held both a full-time and a part-time employment position. She submitted two OCF-2s. The parties disagreed as to the appropriate calculation for the part-time income. The insurer calculated IRBs using the claimant's income for the...

October 22, 2021

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Ganea v. Travelers Insurance (19-012901)

The claimant and the insurer each sought a preliminary issue to answer the following question: was the insurer's request for an OCF-10 and an IE prior to starting IRB payment in accordance with s. 36 of the SABS? Adjudicator Gosio agreed with the insurer that its request for an OCF-10 and an IE prior to...

October 22, 2021

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Mirzaie v. Wawanesa Mutual Insurance Company (19-009605)

The claimant suffered a catastrophic impairment. He sought the purchase of a home for $1.277 million as a rehabilitation benefit. The insurer argued that the claimant failed to prove that a new home was reasonable and necessary, and that the claimant failed to consider the value of modifications to his existing home. Adjudicator Gosio agreed...

October 22, 2021

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Fariad v. Intact Insurance Company (2021 ONSC 6965)

The claimant appealed the Tribunal's decision that he was not involved in an accident. He had been driving an Uber and asked his passengers to leave due to unruly behaviour. After getting out the vehicle, a passenger struck the vehicle. The claimant sped away. He alleged suffering emotional and psychological injuries due to the incident....

October 21, 2021

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Gilani v. Travelers Insurance Company of Canada (19-009248)

A motion was brought by the claimant seeking an order for a contempt hearing because the insurer's occupational therapist failed to attend the hearing to give evidence. The hearing was commenced March 9, 2021 and the IE occupational therapist witness was called by the claimant. Two Summons to Witness were obtained on February 19 and...

October 20, 2021

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Vaillancourt v. Intact Insurance Company (19-009063)

The claimant was injured in an accident and sought benefits including IRBs. The insurer denied the claimant's IRBs based on the claimant not having proper insurance in place to access those benefits relying on the s. 31(1)(a)(i) exclusion for operation of an uninsured vehicle. Adjudicator Chakravarti concluded that the s. 31(1)(a)(i) exclusion did not apply....

October 19, 2021

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Micu v. The Personal Insurance Company (20-006746)

The claimant sought entitlement to attendant care benefits in the amount of $3,079.00 per month. At issue in the hearing was whether the claimant: (a) had proven that she incurred expenses for attendant care, and (b) the service provider sustained an economic loss due to providing attendant care services. The claimant submitted that her partner...

October 19, 2021

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Micu v. The Personal Insurance Company (20-006746)

The claimant sought entitlement to attendant care benefits in the amount of $3,079.00 per month. At issue in the hearing was whether the claimant: (a) had proven that she incurred expenses for attendant care, and (b) the service provider sustained an economic loss due to providing attendant care services. The claimant submitted that her partner...

October 19, 2021

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Nadarajah v. Aviva General Insurance Company (20-009520)

The insurer filed a motion requesting that the Tribunal strike the claimant's reply submissions, contending that the claimant had split his case and provided new submissions in his reply, which prevented the insurer from responding. The insurer argued that is was not only improper but contrary to procedural fairness, and the insurer sought permission to...

October 18, 2021

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Chen and Chen v. Travelers Insurance Company of Canada (20-007653 and 20-007658)

The claimants' daughter was involved in an accident in Ontario. The claimants resided in China at the time. They moved to Canada to assist their daughter with her recovery. They applied for accident benefits under the daughter's policy. The insurer argued that the claimants were not insured persons at the time of the accident. Adjudicator...

October 15, 2021

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Frymus v. Aviva Insurance Canada (19-000055)

The claimant applied to the LAT for entitlement to ACBs. Vice-Chair McGee found that the claimant failed to prove entitlement to ACBs for the relevant time period. It was undisputed that the claimant was entitled to attendant care directly following the accident. At issue before the Tribunal was whether the claimant submitted appropriate proof of...

October 13, 2021

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Dooley v. Aviva General Insurance (20-006951)

The insurer filed a Notice of Motion seeking a ruling that the claimant was precluded from proceeding with his application with respect to IRBs from the date of the loss to 104 weeks post-accident because the claimant failed to submit a Disability Certificate (OCF-3) supporting entitlement. Adjudicator Mazerolle agreed with the insurer and concluded that...

October 12, 2021

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Amare v. Economical Insurance Company (19-004635)

The claimant applied to the LAT seeking entitlement to accident benefits. A preliminary issues hearing was held to determine whether the claimant was involved in an accident, as defined in the SABS. The claimant said that his Samsung mobile phone spontaneously exploded in his pocket while he was driving, and that he hit his head...

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP