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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January 19, 2021

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Jones v. The Co-operators (19-013271)

The claimant applied to the LAT seeking entitlement to IRBs and medical benefits outside of the MIG. At the outset of the hearing, the claimant sought to change his claim for IRBs to a claim for NEBs. Claimant's current counsel advised the LAT that he had not received the claimant's file from a former counsel,...

January 18, 2021

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A.G. v. Allstate Insurance Company of Canada (19-003687)

A preliminary issue hearing was held to determine whether the claimant was barred from proceeding with appealing a claim for neurological assessment that was denied because the claimant was past the two year limitation period. The claimant relied on section 7 of the LAT Act to allow for an extension of time to file an...

January 18, 2021

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Rohile v. Intact Insurance Company (19-009857)

The claimant disputed his entitlement to a partially approved OCF-18 for psychological treatment. The only issue between the parties was the hourly rate for the service provider for the psychological services. The insurer approved the treatment plan at the rate of $99.75 per hour. The claimant argued that the service provider, who was a social...

January 18, 2021

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Alassal v. Co-Operators General Insurance Company (20-004648)

A preliminary issue hearing was held to determine whether the claimant was barred from proceeding with her application for failure to comply with the time limits imposed section 32 of the SABS. The claimant submitted her application nearly 11 months post-accident, despite multiple requests from the insurer for an OCF-1. The claimant's explanation at the...

January 15, 2021

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Manuel v. Certas Direct Insurance Company (19-008341)

The claimant disputed her entitlement to IRBs. The insurer agreed that the claimant was entitled to pre-104 week IRBs and so the central issue in the dispute was whether the insurer could deduct Employment Insurance (EI) maternity benefits and the employer's ""top up"" benefits from the IRB payment. Adjudicator Grant found that the insurer was...

January 15, 2021

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Ramlal v. Aviva General Insurance (19-011325)

The claimant sought to be removed from the MIG and sought entitlement to three treatment plans and the cost of an orthopaedic assessment. Adjudicator Hines concluded that the claimant sustained a minor injury, but was entitled to payment for the disputed treatment plans if they had been incurred prior to receiving proper notice from the...

January 15, 2021

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Sookram v. Zenith Insurance Company (19-012732)

The claimant sought entitlement to NEBs, and seven medical benefits for various treatment and assessments. Adjudicator Watt dismissed all of the claims, holding that the claimant failed to prove entitlement. With regard to the NEB claim, Adjudicator Watt also noted that the claimant was employed at the time of the accident, and that he did...

January 15, 2021

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S.B v. Aviva General Insurance Company (19-004142)

The claimant disputed entitlement to NEBs. The claimant outlined the activities that were important to him before the accident, such as caregiving and spending time with his grandchildren, fishing, hunting with his father and camping. The claimant had a number of pre-existing health issues, but was still able to participate in these activities. As a...

January 15, 2021

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Walcott v. Aviva General Insurance (19-007910)

The claimant sought entitlement to three treatment plans for chiropractic services, one treatment plan for psychological services, and a catastrophic impairment assessment. Adjudicator Grieves noted that given the time elapsed before the claimant reported any accident-related complaints, and that there were only three entries relating to the accident despite seeing her family physician very frequently,...

January 14, 2021

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Verschuren v. the Personal Insurance Company (20-003677)

The claimant was involved in a serios motorcycle accident and was determined to be catastrophically impaired by the insurer. The claimant submitted a treatment plan for a home modification assessment by Adapt-Able Design in the amount of $9,217.40. The insurer partially approved the assessment in the amount of $2,200. The claimant applied to the LAT...

January 13, 2021

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M.O. v. BelairDirect (19-004223)

The claimant applied to the LAT disputing entitlement to NEBs, physiotherapy services, a chronic pain assessment and MIG determination and a special award. The insurer a preliminary issue that the claimant was barred from litigating his entitlement to NEBs for failure to attend an IE to address the benefit. Belair also sought costs. Adjudicator Chakravarti...

January 13, 2021

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C.E. v. Aviva General Insurance Company (18-002591)

This is a reconsideration decision. The hearing decision found that the claimant sustained minor injuries and was subject to the MIG. The claimant requested reconsideration of the hearing decision based on new evidence that was not before the Tribunal at the time of the written hearing and which, he submitted, would likely have affected the...

January 11, 2021

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Kapustin v. Aviva General Insurance (19-013976)

The claimant applied to the LAT disputing entitlement to a treatment and assessment plan for chiropractic treatment. The insurer denied the plan and requested the claimant attend an IE, noting the plan had been submitted four years post-accident and no additional medical documentation had been provided. The claimant attended the IE, but refused to sign...

January 8, 2021

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Hasford v. Aviva General Insurance (19-010256)

A preliminary issue hearing was held to determine whether the claimant was barred from appealing a denial of benefits claimed for MIG determination, IRBs, ACBs, housekeeping, medical benefit expense claims, a CAT determination and a special award. Vice-Chair Boyce held the claimant was statue-barred from appealing the denials due to the claimant's failure to dispute...

January 8, 2021

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Syrovy v. Aviva Insurance Company (19-012498)

The claimant applied to the LAT seeking entitlement to a treatment plan for physiotherapy and sought a special award. Adjudicator Boyce found the claimant was entitled to the treatment plan, plus interest, and given a special award in the amount of $250.00. Adjudicator Boyce found that the insurer's denial letter did not comply with section...

January 8, 2021

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Hodge v. Aviva Insurance Canada (19-005751)

The claimant sought entitlement to IRBs from June 25, 2018 to March 2, 2019. Vice Chair Mather first heard a preliminary issue with respect to the Tribunal's font and spacing specifications. Vice Chair Mather stated that it is open to a party to request an increase in page limits if they do not feel that...

January 8, 2021

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Pollitt v. Certas Home and Auto Insurance Company (19-009201)

The claimant sought entitlement to IRBs in the amount of $885.21 per week, in excess of the statutory maximum of $400.00 per week as set out in the SABS. The insurer initially paid IRBs at the statutory maximum of $400.00 per week, and subsequently reduced payments to $16.00 per week based on the appropriate ""ramp...

January 8, 2021

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White v. Travelers Insurance (19-010567)

The claimant disputed her entitlement to two treatment plans for vision-related services. The insurer denied the treatment plans on the basis that the claimant's vision impairments were not caused by the accident, as the claimant had pre-existing issues with her vision and the neuro-optometry IE assessor found that the claimant's visual impairments were natural history...

January 6, 2021

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N.C. v. Aviva General Insurance Company (19-004666)

The claimant sought reconsideration of the Tribunal's decision dismissing entitlement to medical benefits. Adjudicator McGee noted that the claimant filed her reconsideration submissions nearly a month after the deadline for submissions. Vice Chair McGee did not make any findings on procedural issues for the late findings, as she dismissed the reconsideration application on its merits....

January 6, 2021

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Choi v. Aviva General Insurance Company (20-003741)

The claimant disputed a catastrophic impairment designation. The insurer argued that the claimant failed to attend IEs, and that he was barred from proceeding with the LAT dispute. Adjudicator Lake dismissed the preliminary issue, holding that the insurer failed to prove the claimant failed to attend IEs. According to the documentary record, the claimant did...

January 6, 2021

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H.O. v. Aviva General Insurance (19-002362)

The claimant sought reconsideration of the Tribunal's decision that he did not suffer a catastrophic impairment as a result of the accident. In particular, he challenged the Tribunal's conclusion regarding a 40 percent WPI for cauda equina-like syndrome, and argued that it should have applied. He argued that the Tribunal did not allow procedural fairness...

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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