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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February 12, 2021

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Baldinelli v. Aviva Insurance Company (19-013752)

The claimant was injured in an incident that involved a series of assaults, resulting in physical injuries. The facts of the case are unusual: The claimant heard a commotion on his street. He got in his vehicle and drove down his driveway where he was met by two assailants. The claimant opened the driver's side...

February 11, 2021

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Jamon v. The Co-operators (19-006256)

The claimant sought entitlement to IRBs and various medical/rehabilitation benefits, including an attendant care assessment and functional abilities assessment. With respect to IRBs, Adjudicator Parish found that the claimant had proven on a balance of probabilities that she was substantially unable to perform the essential tasks of her pre-accident employment as a supervisor at Dairy...

February 11, 2021

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Aviva General Insurance Company v. Ghandahari (19-009382)

The insurer requested repayment as a result of benefit payments made based on the claimant's wilful misrepresentation when she failed to disclose that the accident occurred during the course of her employment and she made a claim for benefits from the WSIB. The claimant did not participate in the hearing. Adjudicator Chakravarti agreed with the...

February 10, 2021

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Alakoozi v. ACE INA Insurance (20-000516)

The claimant sought entitlement to benefits following an accident that occurred on December 15, 2016. At the case conference, the insurer raised the preliminary issue that the claimant was statute-barred from proceeding with his claim under s. 56 of the Schedule because he failed to appeal its valid denial within the two-year limitation period. Adjudicator...

February 10, 2021

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Mohammad v. The Dominion of Canada General Insurance Company (20-000007)

The claimant sought entitlement to benefits following an accident that occurred on August 28, 2015. At the case conference, the insurer raised the preliminary issue that the claimant was statute-barred from proceeding with his claim under s. 56 of the Schedule because he failed to appeal its valid denial within the two-year limitation period. A...

February 9, 2021

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Seepersaud v. Allstate Insurance (20-000400)

The claimant sought a special award due to the insurer's unreasonable delay in paying his IRB. Vice Chair Boyce found that the evidence demonstrated that the insurer withheld and delayed the payment of the claimant's IRB claim for over one year of his eligibility, despite having all of the documentation reasonably required to initiate and...

February 8, 2021

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Sheriffe v. Aviva Insurance Company of Canada (19-009684)

This was a preliminary motion decision on the claimant's request for production of adjuster's log notes beyond the date of the LAT application, and the insurer's request for production of a 2010 AB file for a previous accident. Adjudicator Maedel ordered that the insurer produce the log notes beyond the date of the LAT application,...

February 8, 2021

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S.P. v. Aviva General Insurance Company (18-008876)

The claimant sought reconsideration of a LAT dispute denying her entitlement to IRBs and medical benefits. The claimant was represented by counsel at the hearing and with respect to the reconsideration application. Adjudicator Boyce noted that the claimant's reconsideration submissions were 24 pages single spaced and made sweeping accusations that the adjudicator denied her procedural...

February 8, 2021

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Khosla v. TD General Insurance Company (19-010508)

The claimant applied to the LAT disputing her entitlement to a chiropractic treatment plan. The issue in this dispute was the application of sections 38(5) and (6), and the MIG. The insurer denied the treatment plan in accordance with section 38(5) on the basis that the claimant was being treated within the MIG. Later, the...

February 5, 2021

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Cox v. Wawanesa Mutual Insurance Company (19-012281)

The claimant was involved in a serious motor vehicle accident in 2014. She received IRBs for four years, until they were terminated based on multidisciplinary s. 44 opinions. The claimant applied to the LAT seeking entitlement to post-104 week income replacement benefits and a special award. As a preliminary issue, the claimant requested that the...

February 5, 2021

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Duah v. Wawanesa Mutual Insurance Company (19-006610)

The claimant was injured when he slipped and fell on ice while attempting to retrieve his car key from his bag. He suffered a displaced spiral fracture of his fibula. The claimant applied to the insurer for accident benefits. The insurer denied that an accident occurred. The claimant applied to the LAT and the matter...

February 4, 2021

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Z.R. v. Gore Mutual Insurance (18-000017)

The insurer sought reconsideration of the Tribunal's decision that the claimant suffered a catastrophic impairment, and that he was entitled to NEBs. Adjudicator Hines dismissed the reconsideration. She accepted that the Tribunal ought not to have counted 3 percent WPI for medication use because the medication did not have the effect of cancelling out the...

February 3, 2021

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J.J. v. Economical Insurance Company (19-003835)

A preliminary issue hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The claimant submitted that he was riding on the back of an ATV down a laneway on the way to his home when he fell off the back and suffered a...

February 3, 2021

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Escobar v. The Guarantee Company of North America (20-000259)

The claimant sought entitlement to two treatment plans, including a medical benefit for dental treatment and a rehabilitation benefit for a hot tub. The claimant also sought a special award. Adjudicator Grant found that the claimant was entitled to the OCF-18 for dental treatment, but was not entitled to the OCF-18 for a hot tub,...

February 3, 2021

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Shih v. Economical Insurance (20-005669)

The claimant sought entitlement to Income Replacement benefits and three treatment plans. The insurer raised a limitation defence in accordance with s. 56 of the Schedule. The insurer argued that the claimant failed to challenge the denial of the IRB and two of the three treatment plans within the two-year limitation period. Adjudicator Mazerolle found...

February 1, 2021

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Corpuz v. Aviva General Insurance (19-014198)

The claimant applied to the LAT seeking entitlement to medical benefits proposed in two treatment plans. The insurer sought an award of costs in the amount of $1,000.00 on the grounds that the claimant acted vexatiously and in bad faith in the proceeding. The insurer argued that the claimant had misled the LAT by misrepresenting...

February 1, 2021

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Jeyakumar v. Aviva General Insurance (19-010878)

The claimant applied to the LAT seeking entitlement to pre-104 week income replacement benefits. The claimant had returned to work at the time of the hearing and was seeking entitlement to IRBs for the period before he returned to work. Adjudicator Boyce found that the claimant failed to demonstrate that he had a substantial inability...

January 29, 2021

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McQueen v. Aviva Insurance Canada (19-011429)

A preliminary issue hearing was held to determine whether the claimant's application was statute-barred from appealing the denial of IRBs and medical benefits because the claimant failed to commence her appeal within two years. Adjudicator Paluch found that the claimant was statute barred from proceeding with her claim for IRBs and medical benefits . In...

January 29, 2021

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Campbell v. Aviva Insurance Company (19-012095)

The claimant sought entitlement to three treatment plans for chiropractic treatment. Adjudicator Lake found that the claimant was entitled to all three of the treatment plans, plus interest as a result of the insurer's failure to comply with section 38(8). The claimant cited the decision of T.F. v. Peel Mutual Insurance Company, stating that an...

January 29, 2021

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Iqbal v. Gore Mutual Insurance Company (20-005901)

A preliminary issue hearing was held to determine whether the claimant was disentitled to accident benefits because he did not have a reasonable explanation for providing the insurer with notice of the accident and/or failing to apply for benefits within the time limits imposed by section 32(1) of the SABS. Adjudicator Lake held that the...

January 29, 2021

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Aviva General Insurance Company v. Gurung (20-000592)

The insurer sought repayment of all IRBs paid to the claimant, totaling $36,456, based on the claimant failing to notify the insurer that she was earning income as the owner of a restaurant. The insurer argued that it was entitled to repayment of more than one year of IRBs because the overpayment was due to...

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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