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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December 29, 2022

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Nagalingam v. Economical Insurance Company (20-006884)

The claimant sought entitlement to pre-104 week and post-104 week IRBs. The insurer denied the claimant's entitlement and argued that section 33 barred the claim as the claimant failed to provide information relating to his place of residence, which was relevant to a potential section 31 exclusion. Adjudicator Maleki-Yazdi found that the claimant did not...

December 28, 2022

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Thompson v. Aviva Insurance Company (20-005734)

The claimant's spouse was involved in an accident in 2015. In 2019, the claimant applied for accident benefits, including IRBs. The insurer denied the claim on the grounds that the application was submitted late. The claimant applied to the LAT seeking entitlement to IRBs, and two treatment plans related to psychological treatment. Adjudicator Norris granted...

December 23, 2022

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Ni v. Aviva Insurance Company of Canada (20-008774)

The claimant requested a special award for IRBs due to an unreasonable delay by the insurer. As of January 16, 2020, the claimant had provided her OCF-1, OCF-2, OCF-3 and OCF-10 to the insurer. On January 30, 2020, the insurer sent a section 33 request for further income-related documents. The insured made repeated section 33...

December 21, 2022

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Balachandran v. Economical Insurance (21-014940)

The claimant applied to the LAT in order to dispute the hourly rates for ACBs being prescribed by his insurer. Adjudicator Kaur found that the LAT did not have jurisdiction to rule on the matter because there was no dispute regarding the claimant's eligibility to a benefit under the SABS. The amount being claimed in...

December 21, 2022

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Fu v. Pembridge Insurance Company (21-012902)

The claimant applied to the LAT seeking entitlement to NEBs and medical benefits. The insurer argued that the claimant was barred from seeking entitlement to the benefits because he did not dispute the denials within the two-year limitation period. The accident occurred in December 2018, the insurer denied entitlement to NEBs and medical benefits between...

December 21, 2022

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Traders General Insurance Company v. Rumball (2022 ONSC 7215)

Both the insurer and the claimant appealed the Tribunal's decision that the claimant was entitled to IRBs up to the 104 week mark. The insurer appealed the finding that the limitation period did not bar the IRB claim because the denial was not clear and unequivocal. The claimant appealed the finding that she was not...

December 19, 2022

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Sgambelluri v. Aviva Insurance Company (20-009937)

The claimant applied to the LAT seeking entitlement to IRBs and HK expenses. Vice Chair Johal dismissed the claims. Regarding HK expenses, the claimant did not put contemporaneous evidence before the Tribunal proving an impairment with housekeeping activities. The reports the claimant relied upon were all from three years or more post-accident, and did not...

December 6, 2022

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Shalto v. Intact Insurance Company (19-014473)

The claimant was involved in a motor vehicle accident in May 2016. She applied to the LAT seeking CAT determination under Criteria 8 and entitlement to NEBs, ACBs, and numerous medical benefits. Adjudicator Grant applied the "but for" test to the issue of causation and found that although the evidence supported some level of psychological...

December 5, 2022

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Wilmot v. Aviva Insurance Company of Canada (21-002048)

The claimant applied for accident benefits arising out of an accident. There was conflicting information regarding his employment and education. In his OCF-1 , the claimant indicated he was in school, and employed. However, his OCF-3 noted that he had not worked at least 26 of the previous 52 weeks. His OCF-3 also indicated that...

December 1, 2022

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Degazio v. Bertie and Clinton Mutual Insurance Company (21-008359)

The claimant applied for accident benefits arising out of an incident. While the claimant was sleeping in his living room, another vehicle collided with the claimant’s vehicle and struck a corner of the claimant’s home. He did not see the accident occur. The claimant alleged that he sustained psychological and emotional injuries as a result...

December 1, 2022

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Rosoli v. Aviva General Insurance (21-009076)

The claimant had previously filed a LAT Application in 2018 disputing IRBs and several treatment plans. The Application proceeded to a hearing and was dismissed. The claimant did not request a reconsideration of the decision nor did she pursue an appeal. On July 9, 2021, the claimant filed a second LAT Application disputing IRBs, the...

November 30, 2022

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McKay v. Travelers Insurance (20-008456)

The claimant brought an initial application in which the sole issue being raised was whether her injuries fell under the MIG. Adjudicator Watt found that the LAT did not have jurisdiction under the SABS to determine the issue of MIG in in the absence of any specific treatment plan(s) in dispute. Adjudicator Watt stated that...

November 30, 2022

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Nash v. Aviva General Insurance Company (2022 ONSC 6723)

The claimant appealed the Tribunal's decision that he was not entitled to IRBs. The claimant argued that the Tribunal incorrectly applied the SABS, misinterpreted the IRB sections, misapprehended the evidence, and breached natural justice. The Court dismissed the appeal, holding that there were no errors of law committed by the Tribunal. The Tribunal's decision to...

November 25, 2022

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Vaitheeswaran v. State Farm Mutual Automobile Insurance Company (2022 ONSC 6346)

The claimant appealed the Tribunal's decision regarding the quantum of ACBs awarded, and the date interest began to accrue. The claimant also sought judicial review of a FSCO decision relating to housekeeping expenses. The Court dismissed the appeal, holding that the Tribunal did not commit any legal errors in its award of ACBs. The Court...

November 24, 2022

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Basuric v. Dominion of Canada General Insurance Company (2022 ONSC 6148)

The claimant appealed the Tribunal's decision that her application for accident benefits was submitted late without reasonable excuse, and that she was barred from seeking accident benefits. The Court dismissed the appeal, holding that the appeal was on a point of mixed fact and law, and as such was not subject to appeal. The Court...

November 23, 2022

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Beaudin v. Travelers Insurance Company of Canada (2002 ONCA 806)

The insurer appealed the decision of the Divisional Court (which upheld the Tribunal's decision) that a dirt bike involved in an accident was an "automobile" for the purposes of the SABS. The Tribunal had concluded that the dirt bike was required to be insured under the Off-Road Vehicles Act and was not exempt from insurance...

November 18, 2022

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Hansen v. Aviva General Insurance Company (20-012796)

The claimant was involved in an accident and was deemed to be catastrophically impaired on May 23, 2018. The claimant applied for housekeeping and home maintenance (HH) benefits provided by her son prior to her CAT determination, for the period of October 4, 2015 to August 12, 2018. This claim was denied by the insurer....

November 18, 2022

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Ruchlemer v. TD Insurance Meloche Monnex (20-005381)

The insurer raised a preliminary issue and argued that the claimant was barred from applying to the LAT for failure under s. 55 and s.44 of the SABS to cooperate with an IE assessor. Secondly, the insurer argued that the claimant did not suffer a complete inability to carry on a normal life. The claimant...

November 15, 2022

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Allo v. Licence Appeal Tribunal (2022 ONSC 6368)

The claimant appealed the Tribunal's decision denying an adjournment of a scheduled hearing. The Court dismissed the appeal, holding that the denial of the adjournment was an interlocutory step from which no appeal was permitted. The Court allowed the claimant to convert the appeal to a judicial review if proper submissions were made within 10...

November 8, 2022

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Mariyadas v. Wawanesa Mutual Insurance Company (19-011670)

The claimant applied to the LAT for entitlement to IRBs of $400 per week ongoing from the date of loss, a treatment plan for physical therapy, and a special award. The insurer agreed that the claimant met the medical test for IRBs, but disagreed on the quantum. The claimant nevertheless requested that the LAT order...

November 8, 2022

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Dominion of Canada General Insurance Company (Travelers) v Mohamed (20-004572)

The insurer applied to the LAT seeking repayment of IRBs. The claimant did not participate in the hearing. Adjudicator Shapiro found that the claimant failed to advise the insurer that she started a new employment position shortly after the accident and that she received IRBs during the period of post-accident employment. Adjudicator Shapiro found that...

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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