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.

September 25, 2023

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Biniaz-Sarabi v. Gore Mutual Insurance Company (2023 ONSC 5379)

The claimant appealed the Tribunal's decision dismissing her claims for IRBs, ACBs, and various medical benefits. Her submissions focused on the dissatisfaction with the manner the insurer managed the claim. The claimant failed to point to any error of law on the part of the Tribunal. The adjudicator made every reasonable effort to ensure the...

September 20, 2023

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Akinyimide v. Economical Mutual Insurance Company (2023 ONSC 5272)

The claimant appealed the Tribunal's decision that section 31 barred her claim for IRBs. The claimant reported to her insurer that she lived in Windsor, rather than Toronto, when obtaining her auto insurance policy. The misrepresentation resulted in lower premiums. She was involved in an accident in October 2017. The insurer learned of the misrepresentation...

September 13, 2023

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Tyner v. Certas Home and Auto Insurance Company (2023 ONSC 5179)

The claimant appealed the Tribunal's decision regarding a catastrophic impairment, and various medical benefits claims. The claimant sought reconsideration of the decision, which was outstanding at the time of this appeal. The Court dismissed the appeal, holding that the reconsideration decision would be the final order, and that prior to the reconsideration decision, the appeal...

September 11, 2023

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Joaquim v. Intact Insurance Company (2023 ONSC 5120)

The claimant appealed the Tribunal's decision that she was failed to attend an IE in relation to a claimed prescription expense. The claimant argued that the SABS does not permit an IE in relation to prescriptions. The Divisional Court granted the appeal, holding that only items required to be submitted on a treatment plan could...

August 2, 2023

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Kellerman-Bernard v. Unica Insurance Company (2023 ONSC 4423)

The claimant appealed the Tribunal's decision that she could not receive a catastrophic impairment designation because she was not involved in the subject accident. The claimant's son was significantly injured in an accident, and the claimant suffered psychological injuries. The Tribunal held that only persons involved in an accident could apply for a catastrophic impairment...

July 25, 2023

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Abdi v. TD General Insurance Company (2023 ONSC 3536)

The claimant appealed the Tribunal's decision that he did not suffer a catastrophic impairment, as he did not meet the Extended Glasgow Outcome Scale ("GOS-E"). In particular, the adjudicator preferred the assessments of the insurer which took place almost 24 months after the accident, rather than the assessments of the claimant which took place around...

June 30, 2023

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Luluquisin v. Aviva Insurance Company of Canada (2023 ONSC 3912)

The claimant sought judicial review of the Tribunal's decision regarding the quantum of ACBs awarded, and entitlement to various medical benefits. The insurer argued that the decision should have been appealed, rather than the subject of judicial review. The Court agreed with the insurer, holding that judicial review was not warranted and that the Court...

June 20, 2023

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Khan v. Allstate Insurance Company (2023 ONSC 3652)

The claimant appealed the LAT's decision that he did not suffer a catastrophic impairment. The claimant argued that procedural fairness was denied because he did not know the insurer would argue that an intervening event was the cause of his impairments, and argued that the LAT applied the wrong causation test. The LAT dismissed the...

June 15, 2023

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Kahissay v. Intact Insurance (2023 ONSC 3650)

Two claimants sought judicial review of the Tribunal Orders staying their applications while ordering the claimants to attend IEs prior to hearings on catastrophic impairment disputes. The Court held that the judicial review was premature and should not be heard. The cases did not raise exceptional circumstances, absent which the Court would not consider review...

June 7, 2023

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Soldatovas v. Wawanesa Mutual Insurance Company (2023 ONSC 3440)

The claimant appealed the Tribunal's denial of IRBs and a special award, arguing that the decision lacked procedural fairness, reasonableness, and did not consider key evidence. The Court dismissed the appeal, holding that the Tribunal provided the claimant with an opportunity to present his case, and holding that the Tribunal was not required to cite...

June 7, 2023

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Aviva Insurance Canada v. Harland-Bettany (2023 ONSC 3395)

The insurer appealed the Tribunal's decision that the claimant's slip and fall on ice met the definition of accident. The claimant's application included other disputes relating to accident benefits claims that were not yet decided. The Court held that the insurer's appeal was premature as the accident definition decision was interlocutory. The Court wrote that...

May 26, 2023

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Pinera v. Motor Vehicle Accident Claims Fund (2023 ONSC 3155)

The claimant appealed the Tribunal's decision that he was not involved in an accident. The Court dismissed the appeal, holding that the Tribunal's reasons had no error of law, and that the claimant's appeal was largely an attempt to relitigate the factual issues that were before the adjudicator.

May 1, 2023

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Bennett v. Allstate Insurance Company of Canada (2023 ONSC 2609)

The claimant appealed the Tribunal's denial of a special award related to IRBs which were reinstated after the post-104 week mark following further medical assessments. The Court dismissed the appeal, holding that it did not raise an issue of law. The Tribunal's determination regarding the special award were factual in nature, and the Tribunal applied...

April 28, 2023

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Nguyen v. Economical Mutual Insurance Company (2023 ONSC 2541)

The claimant appealed the LAT's decision that the limitation period barred the application. The Court allowed the appeal and remitted the matter to the Tribunal for a new hearing. The Court found the Tribunal erred in concluding that the denial letter was received on the day it was authored, as no evidence was before the...

April 28, 2023

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Sahadeo v. Pafco Insurance Company (2023 ONSC 2542)

The claimant appealed the LAT's dismissal of his catastrophic impairment dispute, arguing that the Tribunal's supplemental reasons contained in the reconsideration decision violated the principles of fairness. The Court dismissed the appeal, holding that the SPPA gave the Tribunal the power to make rules to reconsider its own decision, and that the reconsideration process gave...

April 26, 2023

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Di Giulio v. Aviva General Insurance Company (2023 ONSC 2426)

The claimant sought a stay from Divisional Court of the LAT's decision that the dispute would proceed in writing rather than orally. The Court rejected the stay, holding that there was not a serious issue, there was no irreparable harm if the stay was not granted, and the balance of convenience did not favour the...

April 18, 2023

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TD General Insurance Company v. Duff-Foley (Estate) (2023 ONSC 2400)

The insurer appealed the Tribunal's decision that the settlement between the insurer was valid and enforceable. The claimant died 10 days after settling her tort and AB claims for $957,000, with 60 percent to be structured. The 60 percent was returned to the insurer based on the reversion; however, the claimant's estate took the position...

March 31, 2023

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Garvey v. Economical Insurance Company (20-009618)

The claimant brought a request for reconsideration of a motion order of the LAT dated December 5, 2022 (the "order"), where the LAT denied the claimant's request for an extension to file a request for reconsideration of a previous LAT decision dated August 11, 2022. The claimant's request for reconsideration was dismissed for multiple reasons....

March 31, 2023

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Vettivelu v. Intact Insurance Company (19-006122)

This is a reconsideration decision. The claimant had a written hearing submission deadline of October 19, 2022, but did not file submissions until November 10, which was eight days after the respondent filed a Notice of Motion for an order dismissing the application as abandoned. The claimant requested an adjournment. The motion adjudicator denied the...

March 27, 2023

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Darwich v. The Co-operators (20-015268)

The claimant applied to the LAT for a catastrophic impairment designation and the cost of a private addiction treatment centre. The claimant suffered injuries from an accident that culminated in him being prescribed increasingly higher amounts of morphine to relieve his accident-related back pain. At some point, the claimant’s historic substance abuse issues, which were...

March 23, 2023

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Tran v. Certas Home and Auto Insurance Company (21-004129)

The claimant applied to the LAT for the cost of CAT examinations. The claimant claimed the insurer did not provide adequate medical reasoning in the notice of the denial under section 38(8) of the SABS. The Respondent countered that the notice of denial was adequate based on the request made as there was no medical...

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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