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.

May 26, 2021

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Hines v. TD Insurance Meloche Monnex (19-006324)

The claimant disputed entitlement to IRBs. The insurer sought repayment of IRBs paid to date due to the exclusion barring IRB entitlement when a person is operating an uninsured vehicle (section 31(1)(a)(i)). Adjudicator Farlam dismissed the IRB claim and ordered the claimant to repay all IRBs due to the exclusion. She held that the claimant...

May 26, 2021

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Strickland v. Economical Insurance (20-001811)

The claimant disputed entitlement to various medical benefits. The insurer argued that the dispute was barred due to the claimant's IE non-attendance. Adjudicator Chakravarti held that the dispute could proceed because the IE notice was not in accordance with section 44. The denial of benefits was generic and did not explain why benefits outside the...

May 25, 2021

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Li v. Allstate Insurance (19-004738)

The claimant sought entitlement to IRBs, two treatment plans for physical and psychological therapy, and a special award. Vice Chair Boyce dismissed the claims. The claimant failed to provide sufficient information proving that she was employed at the time of the accident. The Record of Employment suggested that she quit her job a few days...

May 25, 2021

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E.L. v. Wawanesa Mutual Insurance Company (19-003212)

The claimant sought reconsideration of the Tribunal's decision that his IE non-attendance barred the LAT dispute. Adjudicator Makhamra dismissed the reconsideration, holding that the Tribunal properly considered whether the claimant was barred by section 55 from disputing the MIG and the disputed treatment plan. However, Adjudicator Makhamra noted that the decision did not bar the...

May 25, 2021

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A. G.-B. v. Unica Insurance Inc. (19-003153)

The claimant sought payment for accounting invoices related to calculating IRBs. The insurer argued that the accounting report was not reasonable or necessary for calculating IRBs. Vice Chair McGee found the accounting report costs were not payable. The claimant had only one source of income, and the IRB calculation required a simple deduction for short-term...

May 25, 2021

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Abou Hussini v. Travelers Insurance (19-002005)

The claimant sought entitlement to IRBs, removal from the MIG, and various medical benefits. Adjudicator Reilly dismissed all the claims. She held the claimant failed to prove that his accident-related injuries were non-minor, or that she suffered a pre-existing condition that would prevent maximal recovery under the MIG. She found that the allegations of chronic...

May 25, 2021

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J.T. v. Primmum Insurance Company (18-009043)

The claimant sought reconsideration of the Tribunal's decision that he did not suffer a catastrophic impairment, and that his injuries fell within the Minor Injury Guideline. He argued that the Tribunal acted outside of its jurisdiction or violated rules of procedural fairness. Vice Chair Maedel found no error on the part of the Tribunal. The...

May 25, 2021

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Omere v. The Commonwell Mutual Insurance Group (20-007753)

The insurer sought reconsideration of the Tribunal's refusal to decide an IE non-attendance defence upon the claimant's Notice of Withdrawal. Vice Chair Maedel dismissed the reconsideration. Once the claimant withdrew her LAT application, there were no matters in dispute between the parties. The IE non-attendance defence was moot and could not be decided by the...

May 21, 2021

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Manikam v. Aviva Insurance Canada (19-006126)

The claimant sought entitlement to a special award following payment of NEBs after the Case Conference. The insurer admitted that there was a two month initial delay of payment of NEBs. There was also a failure to provide IE reports within 10 days of receipt. A seven month delay in providing the IEs was due...

May 20, 2021

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Dominion of Canada General Insurance Company v. Ridi (2021 ONSC 3707)

The insurer appealed the Tribunal's decision that HST on attendant care benefits is payable above the $6,000 monthly maximum and that HST payments do not come out of the attendant care benefit limits. The Divisional Court allowed the appeal and reversed the Tribunal's decision. The Court held that prior to the June 3, 2019 amendments,...

May 20, 2021

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Habte v. Aviva General Insurance Company (19-008941)

The claimant was injured in a 2017 accident. She applied to the LAT in 2019 disputing, among other things, NEBs. The insurer argued that the failure to submit an OCF-3 within the first 104 weeks barred the claim for NEBs. Adjudicator Lake dismissed the NEBs claim as it was not made in a timely fashion....

May 20, 2021

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Weathers v. Toronto Transit Commission Insurance Company Limited (20-006288)

In 2000, when the claimant was seven years old, he injured his knee while on a TTC bus. The claimant's mother applied for NEBs on his behalf. The OCF-3 submitted by the claimant's family physician did not support entitlement to NEBs. In 2001, the TTC sent correspondence to the claimant stating that NEBs were not...

May 18, 2021

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Nelson v. Travelers Insurance Company of Canada (19-012673)

The claimant sought entitlement to ongoing IRBs, removal from the MIG, and four treatment plans for physiotherapy and two assessments. Vice Chair McGee dismissed the claims. She held that the claimant failed to prove that she suffered from a non-minor injury. Her alleged chronic pain was not serious enough to qualify as non-minor. The claimant...

May 14, 2021

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Green v. Intact Insurance Company (19-013031)

The claimant sought entitlement to $10,400 multidisciplinary reports addressing entitlement to post-104 week IRBs. Vice Chair McGee dismissed the claims, holding that the SABS did not provide entitlement to post-104 week IRBs assessments. Section 25 lists the types of examinations and assessments an insurer was required to fund. The section does not require payment of...

May 14, 2021

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Grewal v. Peel Mutual Insurance Company (20-010308)

The claimant sought to add a claim for punitive damages to his LAT application. Adjudicator Mazerolle held that the Tribunal did not have jurisdiction to award punitive damages in accident benefits disputes. The Tribunal's jurisdiction was limited to matters provided for in the Insurance Act and Regulations. The Legislature provided clear authority to the Tribunal...

May 13, 2021

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Sterling v. Heartland Farm Mutual Inc. (20-000672)

The claimant sought entitlement to accident benefits after an incident in which she experienced intense neurological pain in her back and loss of sensation in her right leg and foot while pressing her foot onto the accelerator. Prior to starting the vehicle, the claimant had lifted her 30 pound son into his car seat. Vice...

May 12, 2021

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Switzer v. Waterloo Insurance (19-011403)

The claimant disputed his entitlement to attendant care benefits, housekeeping expenses, and two chair lifts. He also disputed the weekly quantum of IRBs he was entitled to receive. The claimant also sought a special award. The insurer argued that the accident was not the cause of the claimant's impairments, and that they all pre-existed the...

May 12, 2021

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M.I. v. Coseco Insurance Company (18-000742)

The claimant sought reconsideration of the Tribunal's decision that it did not have jurisdiction to award ongoing IRBs, and the dismissal of a claim for a special award and interest. IRBs had been reinstated prior to the initial hearing, so there was no dispute as to entitlement or quantum. Vice Chair Maedel dismissed the reconsideration...

May 11, 2021

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Hosseini v. Economical Mutual Insurance Company (20-004222)

The insurer sought production of the claimant's AB file from a 2007 accident, and the LTD file relating to the same accident. The claimant argued that the materials were not relevant, as they related to an incident more than 10 years prior to the subject accident. Adjudicator Lake ordered the claimant to produce the full...

May 8, 2021

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Majeed v. Aviva General Insurance Company (20-004520)

The claimant sought entitlement to ACBs of $1,017 per month, occupational therapy services, and assistive devices. Adjudicator Mazerolle denied the claim for ACBs. First, he held that the claimant was not entitled to claim ACBs prior to submission of the Form 1. Second, the only invoices for services pre-dated submission of the Form 1. Third,...

May 6, 2021

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N.F. v. Aviva Insurance Company (18-007077)

The insurer sought reconsideration of the Tribunal's award of IRBs of $400.00 per week from March 2 to December 18, 2018. The insurer argued that the Tribunal erred by awarding IRBs during the period November 1 to December 18, 2018 when the claimant returned to work on a modified basis. Adjudicator Mazerolle agreed with the...

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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