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 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...

May 6, 2021

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Randhawa v. Unifund Assurance Company (19-010821)

The claimant sought entitlement to NEBs up to the 104 week mark. Adjudicator Parish held that the claimant did not meet the disability test and dismissed the claim. She accepted that the claimant had psychological impairments, but that the impairments pre-dated the accident. She also made an adverse inference about the claimant's occupational activities due...

May 5, 2021

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Williams v. Aviva General Insurance Company (19-007941)

The claimant applied to the LAT disputing entitlement to IRBs. The insurer denied entitlement in June 2017. The LAT application was made in July 2019. Adjudicator Lake accepted that the LAT dispute was commenced outside the limitation period by a few weeks, and thus barred by the limitation period. She also held that she did...

May 5, 2021

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Kechichian v. Primmum Insurance Company (19-008194)

The claimant sought entitlement to NEBs. The insurer argued that the limitation period barred the dispute. Adjudicator Lake held that the limitation period applied and that she did not have jurisdiction to extend the limitation period under the LAT Act. She also held that she did not have jurisdiction to apply the doctrine of equitable...

May 5, 2021

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Dino v. Travelers Insurance (20-005704)

The insurer brought a motion for suspension of the claimant's benefits due to his failure to attend an examination under oath seven months prior to a scheduled hearing. Adjudicator Mazerolle granted the suspension. He rejected the claimant's argument that there was a temporal limitation on when an insurer could request an examination under oath. The...

May 4, 2021

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B.A. v. Economical Mutual Insurance Company (18-005968)

The claimant applied for reconsideration of the Tribunal's decision that section 31 barred his claim for IRBs because of a material misrepresentation relating to her address, which resulted in lower insurance premiums. Vice Chair Johal dismissed the reconsideration request. The Vice Chair held that the Tribunal did not err in allowing evidence of the phone...

April 30, 2021

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Boateng v. Allstate Insurance Company of Canada (19-014193)

A preliminary issues hearing was held to address whether the claimant was barred from proceeding with his claim for NEBs as he failed to submit an OCF-10 electing NEBs. The claimant submitted an OCF-3 supporting IRBs and NEBs. The insurer requested the claimant submit a completed OCF-10 election of benefits. The claimant failed to submit...

April 30, 2021

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Polat v. TD Home and Auto Insurance Company (20-002912)

The insurer raised two preliminary issues in advance of the hearing: (1) to bar the claimant from proceeding with her claim for IRBs due to failure to commence her application withing the two year limitation period; and (2) to dismiss the application for procedural delay and awarding costs. Vice Chair Boyce found the applicant was...

April 30, 2021

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A.J. v. Security National Insurance Co (18-007658)

The claimant sought a special award on the basis that the insurer unreasonably withheld and delayed payment of her claim for NEBs. The insurer failed to acknowledge receipt of the claimant's OCF-3, and ignored several requests from the claimant requesting confirmation and updates on the status of payments. The insurer had no explanation as to...

April 29, 2021

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Bagla v. TD Insurance Meloche Monnex (20-004159)

The preliminary issue in this matter was to determine whether the claimant was limitation-barred from disputing entitlement to ACBs in relation to two accidents due to his failure to dispute the denials within two years. Adjudicator Boyce concluded that the claimant was limitation-barred on both ACB claims. Pursuant to s. 56 of the Schedule, an...

April 29, 2021

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M.N. v. Aviva General Insurance (19-001788)

The insurer raised a preliminary issue in respect to whether the claimant was involved in two accidents. Adjudicator McGee found that the claimant was involved in both an April 8, 2016 accident and an October 4, 2016 accident. The facts of this case are unusual. At the time of both accidents, the claimant was incarcerated...

April 28, 2021

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Porter v. Aviva Insurance Company of Canada (2021 ONSC 3107)

The insurer appealed the Tribunal's decision that the claimant was involved in an accident. The claimant slipped and fell on ice while making her way to a Lyft vehicle in her driveway. The Court granted the appeal and concluded that the facts of loss did not qualify as an accident. The Tribunal erred by conflating...

April 28, 2021

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Harsanyi v. The Co-operators General Company (20-001245)

A preliminary issues hearing was held to determine whether the claimant's claim for IRBs was barred pursuant to s. 31(1)(a)(ii) of the SABS, which provides that an insurer is not required to pay an IRB if the claimant was driving an automobile without a valid driver's licence. The claimant asserted that he was unaware at...

April 28, 2021

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tgp-admin

B.F. v. Certas Direct Insurance Company (19-004944)

The claimant applied to Certas for accident benefits. Certas brought an application to the LAT arguing that the claimant was not involved in an "accident" and sought repayment of accident benefits because the claimant wilfully misrepresented facts in relation to her application for benefits. Adjudicator Maleki-Yazdi agreed that the claimant was not involved in an...

April 27, 2021

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Borsato v. Pembridge Insurance (19-013826)

A preliminary issues hearing was held to determine whether the claimant was involved in an "accident" as defined in s. 3(1) of the SABS. The claimant and insurer agreed on the following facts: On the day of the accident, the claimant drove to a feed store with her husband to purchase horse feed. The claimant...

April 27, 2021

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F.C. v. Aviva General Insurance (19-003936)

The claimant disputed her MIG determination and her entitlement to medical benefits. In regard to the MIG, Adjudicator Moten found the claimant's prior injury to her coccygeal region prevented maximal recovery if she were limited to the $3,500 minor injury limits. Adjudicator Moten also found there was compelling evidence in the claimant's health practitioners' medical...

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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