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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.

June 15, 2021
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tgp-admin

Fratarcangeli v. North Blenheim Mutual Insurance Company (2021 ONSC 3997)

The Divisional Court considered three LAT decisions addressing section 7 of the LAT Act, to determine whether the Tribunal had the power to extend the two-year limitation period. The Court held that the LAT Act did grant the Tribunal the power to extend the limitation period and upheld two of the decisions in which the...
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June 11, 2021
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tgp-admin

Dankha v. Aviva Insurance Company (19-009569)

The claimant applied to the LAT seeking removal from the MIG, entitlement to three treatment plans, and a special award. Prior to the LAT hearing, the insurer removed the claimant from the MIG and approved all the treatment plans, so the only issue at the hearing was whether the claimant was entitled to a special...
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June 11, 2021
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tgp-admin

Basuric v. Dominion of Canada General Insurance Company (20-007187)

The insurer raised a preliminary issue, arguing that the claimant's claim was barred pursuant to section 55 of the SABS because she failed to notify the insurer of her intention to apply for accident benefits until over three years after the accident. Both parties agreed that the claimant failed to comply with the time limit...
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June 10, 2021
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tgp-admin

Travelers Insurance Company of Canada v. Matich (19-008573)

The insurer applied to the LAT seeking repayment of IRBs. The claimant did not participate in the hearing. Adjudicator Grant found the evidence established the insurer paid the claimant an IRB during a period when the claimant had returned to work and had failed to notify the insurer of same. The insurer relied upon statements...
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June 9, 2021
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tgp-admin

Polis v. Aviva General Insurance (20-000025)

The claimant sought entitlement to IRBs and ACBs. Adjudicator Kaur found that the claimant did not suffer a substantial inability to perform the tasks of her pre-accident employment as a result of the subject accident. The claimant was not working at the time of the accident due to a prior workplace injury, and her family...
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June 9, 2021
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tgp-admin

A.B. v. The Co-Operators Insurance Company (19-004401)

The claimant applied to the LAT seeking entitlement to benefits after being involved in an automobile accident in 2016. The insurer raised two preliminary issues: 1) Was the claimant statue-barred from proceeding with a claim for NEBs for failure to commence the application within the two year limitation period; and 2) Was the claimant entitled...
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June 8, 2021
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tgp-admin

Hardy-MacDonald v. Wawanesa Mutual Insurance Company (20-005392)

The preliminary issue in this matter was whether the claimant was barred from commencing a proceeding because she failed to comply with Section 44 of the Schedule by not attending insurer's examinations. Adjudicator McGee dismissed the application due to the claimant's failure to attend the IEs. The claimant submitted that she was not required to...
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June 7, 2021
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tgp-admin

Amani v. Certas Home and Auto Ins. (19-013741)

A preliminary issue hearing was held to address whether the claimant was barred from proceeding with her claim for ACBs and NEBs due to failure to commence an application within the two year limitation period. Vice-Chair Boyce determined that the application for ACBs was not properly before the Tribunal but that an exercise of discretion...
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June 3, 2021
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tgp-admin

Asher v. Wawanesa Mutual Insurance Company (19-013046)

A preliminary issue hearing was held to address whether the claimant was barred from proceeding with her claim for IRBs due to failure to commence an application within the two year limitation period. The claimant submitted that the insurer was estopped from arguing that the limitation period and the legislation ought to be construed in...
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June 2, 2021
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tgp-admin

Shpati v. Travelers Canada (19-008988)

The claimant disputed the insurer's determination that her injuries fell within the MIG, as well as her entitlement to various medical/rehabilitation benefits. The claimant made no submissions and made no reference to any evidence of a non-MIG injury, but rather made a broad claim that all of the insurer's denials failed to comply with section...
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June 1, 2021
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tgp-admin

Z.R. v. Certas Direct Insurance Company (18-001468)

The claimant sought reconsideration of the Tribunal's decision that he did not suffer a catastrophic impairment under section 3.1(1)(5)(i), which requires positive findings of a traumatic brain injury on a CAT scan, MRI, or other medically recognized brain diagnostic technology. Adjudicator Gosio rejected the reconsideration. The claimant did not make any arguments regarding the French...
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May 28, 2021
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tgp-admin

A.H. v. Unica Insurance Inc. (18-012320)

The claimant applied for reconsideration of the Tribunal's decision that he was not entitled to IRBs because he was not employed at the time of the accident. The claimant was scheduled to start a job two weeks after the accident. Because of the accident, he was unable to start the job. Adjudicator Grieves dismissed the...
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May 28, 2021
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tgp-admin

Munro v. Belair Direct (19-013690)

The claimant suffered a catastrophic impairment in an accident that resulted in the death of his son. He sought entitlement to various medical benefits, including nursing services, a meditation system, a portable modulation stimulator device, naturopathic treatment, an ozone generator device, and an infrared sauna. Some of the claimed services were submitted on an OCF-6....
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May 28, 2021
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tgp-admin

Amiri and Mireskandari v. The Co-operators (20-003296 & 20-003319)

The claimants made a claim for accident benefits following an incident in which they witnessed a vehicle strike a close family member (spouse and father-in-law, respectively). The incident was only a few feet in front of the claimant. The claimants heard the collision and witnessed the aftermath. The claimant alleged that they suffered psychological injuries....
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May 26, 2021
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tgp-admin

Solanes v. Aviva General Insurance (20-001140)

The claimant sought entitlement to ACBs, and the cost of two assessments. Adjudicator Chakravarti denied entitlement to all claimed benefits. ACBs were stopped at the 104 week mark, so the claimant could not claim ACBs unless she sustained a catastrophic impairment. The claimant failed to provide the Tribunal with the disputed treatment plans, so the...
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May 26, 2021
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tgp-admin

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...
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May 26, 2021
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tgp-admin

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...
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May 25, 2021
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tgp-admin

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...
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May 25, 2021
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tgp-admin

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...
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May 25, 2021
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tgp-admin

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...
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May 25, 2021
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tgp-admin

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

416.507.1800

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eodonnell@tgplawyers.com