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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December 4, 2020

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P.W. v. Wawanesa Mutual Insurance Company (18-007187)

The claimant sought reconsideration of the Tribunal's decision which found that her injuries fell within the Minor Injury Guideline. The claimant argued that the Tribunal erred in law by creating and applying an incorrect test to decide the issues in dispute. Specifically, the claimant stated that she was not taken out of the MIG despite...

December 4, 2020

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Mattina v. Federated Insurance Company of Canada (19-011267)

The claimant sought entitlement to a treatment plan for physiotherapy. The insurer argued that it was not liable to pay the disputed treatment plan because it was not signed by the claimant or a health care professional as required by section 38(3). The insurer had not raised the issue of noncompliance with section 38(3) in...

December 4, 2020

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A.M. v. Aviva Insurance Company of Canada (18-008059)

The claimant requested reconsideration of the Tribunal's decision denying NEBs and holding the claimant in the MIG. Adjudicator Norris denied the reconsideration. The claimant argued the insurer gave no evidence to subject the claimant to the MIG and the insurer's reports did not provide an opinion on the application of the MIG. The insurer submitted...

December 3, 2020

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R.K. v. Allstate Insurance (19-000502)

This is a reconsideration decision of Adjudicator Shapiro. The claimant sought reconsideration of the LAT's dismissal of the claimant's dispute for medical benefits. There was also a procedural issues as Adjudicator Shapiro made a finding on attendant care benefits entitlement in the first instance, despite the fact that this issue was withdrawn by the claimant....

December 3, 2020

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Z.J. v. Aviva Insurance Company of Canada (18-012030)

The insurer requested reconsideration of a decision in which the Tribunal found the claimant was entitled to partial payment of the cost of multidisciplinary CAT assessments and fees for the completion of the OCF-18 and OCF-19. Adjudicator Braun denied the request for reconsideration. The insurer argued that a chiropractor was not authorized to provide an...

December 3, 2020

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Lin v. Aviva Insurance Canada (19-006064)

The claimant sought to IRBs and further chiropractic treatment. The insurer raised a preliminary issue that the claimant improperly relied on three exhibits that were not previously served on the insurer and sought to have them struck. Adjudicator Norris agreed holding that the claimant failed to submit evidence to prove that the documents were previously...

December 3, 2020

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R.C. v. Co-Operators General Insurance Company (19-012539)

The claimant was involved in a motor vehicle accident in April 2013, in which he allegedly sustained injuries to his back and shoulder, as well as psychological impairments. The claimant was incarcerated 13 days later, and was in and out of provincial institutions over the next four years. The claimant also struggled with drug addiction...

December 2, 2020

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Mais v. Aviva Insurance Canada (19-008068)

The claimant disputed his entitlement to NEBs. The insurer requested that the matter be dismissed due to the claimant's failure to provide documents that had been ordered produced at the Case Conference, and for failure to make written submissions for the hearing. The preliminary motion was dismissed, but Adjudicator Farlam held that the claimant failed...

December 2, 2020

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F.J. v. Aviva Insurance Canada (18-010144)

The claimant sought entitlement to NEBs and five medical benefits. Adjudicator Shapiro found that the claimant was entitled to three of the treatment plans, but not NEBs. In referencing Heath v. Economical, the adjudicator found that the claimant failed to show that she was continuously prevented from engaging in substantially all of her daily activities....

December 2, 2020

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B.M. v. Aviva Insurance Company (18-009572)

The claimant disputed entitlement to three treatment plans for physiotherapy and chiropractic services, and a special award. Both parties raised preliminary issues at the hearing: the claimant alleged that the insurer failed to give appropriate notice under section 38, while the insurer alleged that the claimant failed to comply with the Tribunal's rules of disclosure...

December 1, 2020

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Gordon v. Royal & Sun Alliance (19-012000)

The claimant sought removal from the MIG and entitlement to various medical benefits. The insurer scheduled IEs, which the claimant refused to attend, arguing that the insurer should conduct a paper review. Vice Chair McGee rejected the claimant's argument that section 44(3)(a) bars the insurer from requesting an in-person IE for a MIG determination. Moreover,...

November 30, 2020

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Williams v. Wawanesa Mutual Insurance Company (19-007941)

The insurer sought an order that the claimant's application for IRBs was time barred since it was commenced more than two years after the denial. The insurer had written to the claimant and her legal representative of the stoppage, provided the claimant with a copy of the IE report and advised of the right to...

November 27, 2020

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L.L.B. v. Intact Insurance Company (17-003125)

This is a decision over the definition of "accident" in the SABS. This case has a long history. The claimant and the insurer disagreed over whether an accident occurred. The claimant was working as a crew member of a television production company in downtown Toronto. Her job was to keep watch over three dedicated parking...

November 27, 2020

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Mann v. Aviva Insurance Company (19-007477)

The claimant sought entitlement to a psychological assessment and a chronic pain assessment, plus a special award. As a preliminary matter, the parties' submissions refer to a disagreement over whether the psychological assessment was withdrawn with prejudice by the claimant at a previous case conference in an earlier Tribunal matter. Adjudicator Maleki-Yazdi found that the...

November 26, 2020

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Patchett v. Optimum Insurance Company (19-008902)

The claimant applied for a catastrophic impairment under Criterion 2(iii) of the new definitions, requiring a SCIM score of five or less on an indoor mobility test. The claimant's score was below five shortly following the accident when she was recovering from fractures in her extremities. However, the score was above five after a number...

November 25, 2020

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Ai v. Intact Insurance Company (19-005110)

The claimant requested reconsideration of the Tribunal's previous decision barring his LAT Application for refusal to attend IEs. The claimant alleged that Vice-Chair Farlam did not properly interpret the SABS, that the statutory notice requirements in the IE notice letters was not met, and that the IEs should have proceeded by way of paper review...

November 25, 2020

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B.L.J. v. The Co-Operators Company (18-012005)

The claimant applied to the LAT seeking entitlement to medical benefits, IRBs, and ACBs. Prior to the accident, the claimant worked full-time at a restaurant. After the accident, she was off work for several months before starting a volunteer position at a residence for assisted living that transitioned into a part-time job. She continued to...

November 25, 2020

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Aviva General Insurance Company v. Muthusamythevar (19-009392)

The insurer applied to the LAT seeking repayment of an overpayment of IRBs made as a result of wilful misrepresentation. Adjudicator Boyce found that the insured failed to notify the insurer when he returned to full-time work, and he continued to collect IRB payments while working full time. Adjudicator Boyce agreed with previous LAT decisions...

November 24, 2020

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Bhullar v. TD Insurance Meloche Monnex (19-010667)

The claimant sought entitlement to two treatment plans for chiropractic services, massage therapy, and physiotherapy. The insurer submitted that it was not liable to pay either treatment plan in dispute because neither were signed by the health care provider and the claimant as required by section 38(3). The claimant argued that the first time the...

November 23, 2020

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R.M. v. CAA Insurance (19-003499)

The insurer sought an order barring the claimant from proceeding with her application due to non-compliance with the limitation period. The insurer had denied further payment of NEBs by way of letter dated October 4, 2016, which was mailed to the claimant and faxed to her counsel. The claimant applied to the Tribunal on November...

November 19, 2020

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D.Y. v. Aviva General Insurance (18-011171)

The insurer sought reconsideration of the Tribunal's decision awarding payment of non-earner benefits, concussion management treatment and ordering a special award. Vice Chair Trojek granted the insurer's request for reconsideration in part. With respect to the concussion management treatment, Vice Chair Trojek noted that the Tribunal made an error of law in not considering whether...

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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