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.

July 28, 2021

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Johnson v. Jevco (2021 ONSC 4870)

The insurer appealed the Tribunal's reconsideration decision which concluded that the motorcycle operated by the claimant was insured under its policy as a ""newly acquired automobile"". The claimant had purchased the motorcycle 11 days before the accident, but did not notify the insurer until one month after the purchase. The ""newly acquired automobile"" provision of...

July 27, 2021

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Ahmed v. Aviva Insurance Company (19-999565)

The insurer brought a motion to dismiss the LAT application as abandoned; the claimant opposed the motion, and sought costs in response. The claimant was 64 years old, visually impaired, and did not speak English. The Case Conference took place on April 1, 2020. The written hearing was scheduled for November 30, 2020. In a...

July 20, 2021

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Kosiner v. Economical Insurance Company (19-007787)

This is a reconsideration decision. The claimant was self-represented. He attended the case conference and settled his file with Economical, which was confirmed in writing. Over one year later, the claimant filed a Notice of Motion to set aside the settlement and raised issue with the fact that Economical would not renew his insurance policy....

July 19, 2021

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Spiegel v. Intact Insurance Company (20-000279 & 20-000408)

Intact requested a preliminary issue hearing as the claimant failed to attend insurer examinations. Intact requested that two issues for medical benefits be barred from dispute pursuant to section 55. The claimant was involved in two accidents which were joined into a single matter for the purpose of the preliminary issues hearing. The two disputed...

July 19, 2021

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Hamad v. Travelers Insurance (19-014581)

A preliminary issue hearing was held to determine whether the claimant was barred from proceeding with her claim for NEBs and medical benefits after failure to submit to an insurer's examination under section 44 of the SABs. The claimant submitted an OCF3 supporting an entitlement to NEBs but containing no medical evidence. The insurer requested...

July 14, 2021

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A.H. v. Aviva Insurance Canada (19-004639)

The claimant applied to the LAT seeking entitlement to IRBs and medical benefits. Vice-Chair McGee found that the claimant failed to meet the substantive test for IRBs. The claimant submitted that under s. 36 of the SABS the insurer was required to pay IRBs for a five-month period because the insurer failed to request insurer...

July 14, 2021

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Duval v. Aviva General Insurance (20-001990)

The claimant disputed entitlement to $1,030.84 in monthly attendant care benefits, treatments plans for cannabis and an orthopaedic mattress, interest, and a special award. Aviva initially accepted the Form 1 and paid attendant care invoices as they were submitted. Aviva then denied attendant care based on an orthopaedic assessment and Form 1. The claimant argued...

July 14, 2021

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Northbridge Personal Insurance Corporation v. Robinson (19-009743)

The claimant suffered injuries which rendered him paraplegic while attempting to load a GMC Sierra truck onto a trailer in order to move it to another location to be repaired. The trailer was attached to a Dodge truck driven by one of the claimant's friends. The insurer sought a determination of whether the incident met...

July 14, 2021

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Kyrylenko v. Aviva Insurance Canada (2021 ONSC 4929)

The claimant appealed the Tribunal's decision that he was not entitled to payment for benefits related to two treatment plans that the insurer had failed to respond to within 10 business days. Despite the language of section 38(11), the Tribunal considered whether the medical benefits were reasonable and necessary, and whether the MIG applied and...

July 14, 2021

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Ali v. Aviva Insurance Company of Canada (19-013677S)

The claimant submitted that the insurer failed to comply with its obligations under section 38(8) regarding its notices that denied the disputed treatment plans. Adjudicator Lake found that the insurer's response letter failed to provide any specific details about the claimant's condition that formed the basis of its decision, and failed to provide an explanation...

July 12, 2021

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

A motion was brought by the claimant for an order to add additional witnesses (the current claims adjuster and the case manager) and to allow the filing and use of certain documents from the OT's updated records requested by the insurer to be admitted into evidence. The motion to add the two additional witnesses was...

July 12, 2021

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P.P. v. Wawanesa Mutual Insurance Company (18-000957)

The claimant sought reconsideration of the Tribunal's decision that he did not suffer a catastrophic impairment and that he was not entitled to IRBs. With regard to the catastrophic impairment, he argued that the Tribunal erred in not counting 3 percent WPI for medication and 18 percent WPI for a potential future operation. Adjudicator Flude...

July 9, 2021

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Manoharan v. Allstate Canada (19-010782)

Allstate filed for reconsideration of the Tribunal's decision which Vice-Chair Boyce ruled in the claimant's favour and awarded her interest on the incurred amounts of three treatment plans and various other benefits. Allstate argued that Vice-Chair Boyce erred in fact and law in relation to section 38 and section 51, and that no interest was...

July 9, 2021

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Lo v. Allstate Insurance Company of Canada (20-003717)

The claimant sought entitlement to a special award in relation to a physiotherapy treatment plan, arguing that the insurer had "ample evidence as to the existence of the impairments she suffered." The claimant further submitted that the refusal was unreasonable and caused a substantial delay in the claimant's ability to access treatment that was recommended...

July 7, 2021

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Snagg v. Certas Home and Auto Insurance Company (20-003642)

A preliminary issue hearing was held to address whether the claimant was barred from proceeding with his claim for NEBs due to failure to submit a completed OCF-3. The claimant submitted an OCF3 which endorsed that he did not meet the test for NEBs. The insurer subsequently denied NEBs which led to the claimant commencing...

July 5, 2021

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tgp-admin

Richards v TD General Insurance Company (20-001799)

The claimant was injured in an accident on December 2, 2016 and applied for benefits. The insurer denied the claim for NEBs. The preliminary issue for the Tribunal was whether the policy of insurance was entered into or renewed before June 1, 2016 such that the claimant would have access to the pre-June 1, 2016...

July 2, 2021

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Carpizo v. Co-operators General Insurance Company (20-007999)

A preliminary issue hearing was held to address whether the claimant was entitled to payment of NEBs until the substantive hearing based on the insurer's failure to comply with section 36 of the SABS. Adjudicator Farlam found that the claimant was not entitled to the payment of NEBs until the substantive hearing and that the...

June 30, 2021

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Sadni v. Allstate Canada (20-000670)

The claimant applied for accident benefits following a motorcycle accident. The insurer argued that the motorcycle was not insured at the time of the accident, and that section 31 applied to bar entitlement to IRBs. Adjudicator Boyce agreed with the insurer that the motorcycle was not insured, and that the claimant was not entitled to...

June 29, 2021

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S.B.S. v. Wawanesa Mutual Insurance Company (17-006935)

The claimant filed a request for reconsideration arising out of Adjudicator Neilson's decision that he was not entitled to IRBs or the cost of a psychological treatment plan. Adjudicator Neilson dismissed the request. At the initial hearing, the claimant brought a motion to exclude the insurer's experts' reports on the basis that the insurer failed...

June 29, 2021

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tgp-admin

Malitskiy v. Unica Insurance Inc. (2021 ONSC 4603)

The claimant appealed the LAT reconsideration in which the Tribunal held that he was only entitled to ACBs calculated by using the Form 1 hourly rate multiplied by the time received for each service (rather than the full Form 1 amount of $6,000), and the Tribunal's decision that the claimant was not entitled to a...

June 29, 2021

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tgp-admin

Liao v. Aviva General Insurance (19-004856)

The claimant applied to the LAT seeking entitlement to IRBs and a treatment plan proposing chiropractic treatment. The claimant submitted that she attempted to return to work after the April 2016 accident but ceased working in August 2016 due to accident-related impairments. The insurer argued that the claimant was not entitled to IRBs because she...

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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

416.507.1850

eodonnell@tgplawyers.com