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.

April 20, 2021

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Rida v. Wawanesa Mutual Insurance Company (19-013934)

The claimant was declared catastrophically impaired and sought payment of attendant care benefits and housekeeping benefits provided by her daughters. The insurer ultimately accepted that the claimant was entitled to payment of the benefits, and argued that since it agreed with the claim, there was no basis upon which a special award could be granted....

April 14, 2021

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Z.J. v. Wawanesa Mutual Insurance Company (18-008967)

The claimant sought reconsideration of the decision of Adjudicator Maleki-Yazdi wherein she found that the claimant was not in an accident. Adjudicator Maleki-Yazdi upheld her previous decision. Adjudicator Maleki-Yazdi noted that the Tribunal reviewed all of the evidence, including the expert reports about whether the accident was staged, and that she did not err in...

April 14, 2021

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Xie v. Allstate Insurance Company of Canada (20-001171)

The claimant disputed the insurer's decision to keep her in the MIG, as well as her entitlement to various medical benefits. The insurer argued that the claimant had failed to comply with its section 33 requests for medical records, and as such, was not liable to pay any benefit. Adjudicator Grant agreed, noting that the...

April 14, 2021

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Williams v. Allstate Insurance Company (19-013488)

The claimant disputed the insurer's decision to keep him in the MIG, as well as his entitlement to various treatment plans. Prior to the filing of hearing submissions, the insurer removed the claimant from the MIG and approved all of the disputed treatment plans. As a result, the only issue in dispute in the hearing...

April 12, 2021

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Wangden v. Economical Insurance (19-010637)

The claimant disputed entitlement to the MIG, NEBs, and various medical benefits. The claimant argued that they were entitled to payment of NEBs due to Economical's failure to comply with the timeline under section 36(4). The insurer argued that the claimant was barred from litigating NEBs for failure to attend a scheduled IE to address...

April 9, 2021

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Ladene v. Intact Insurance Company (19-013428)

The claimant was involved in a motor vehicle accident in Alberta while driving a vehicle registered in Alberta and insured under an Alberta policy. She applied for and received benefits in Alberta under Alberta protocols. She then moved to Ontario and applied for benefits pursuant to the SABS. The claimant argued that she could elect...

April 9, 2021

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Polidori v. Motor Vehicle Accident Claims Fund (19-009160)

The insurer sought reconsideration of a decision in which the Tribunal ordered it to pay the cost of an in-home occupational therapy assessment and a special award of 40%. Vice Chair McGee denied the insurer's request, finding that it had not established any of the grounds for reconsideration. She noted that the Tribunal's assessment of...

April 8, 2021

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Harvey v. TD Insurance Meloche Monnex (19-008497)

The claimant applied to the LAT seeking entitlement to incurred ACBs, occupational therapy, and a special award. The insurer raised two preliminary issues: 1) Did the LAT have jurisdiction to adjudicate the ACB issue as the benefit had been suspended for non-compliance with s. 33 requests rather than denied; and 2) Was the claimant barred...

April 8, 2021

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Siklis v. Aviva Insurance Canada (19-007597)

The claimant applied to the LAT to dispute several treatment plans. At the case conference, the insurer raised two preliminary issues: (1) whether the claimant was statute barred from pursuing his claim for medical benefits due to the two year limitation; and (2) if not, whether the claimant was precluded from proceeding with his claim...

April 7, 2021

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

The insurer requested reconsideration of the Tribunal's decision awarding post-104 IRBs entitlement and interest. The insurer submitted that the Tribunal erred when it relied on the trial decision in Burtch v. Aviva that post-accident employment that is substantially different in nature, status, and renumeration may not be considered an appropriate alternative. The insurer noted that...

April 7, 2021

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R.L. v. Intact Insurance Company (18-005036)

The claimant sought reconsideration of a decision in which she was statute barred from disputing her claim for NEBs. The claimant argued that the original decision erred in law because: (1) it found that a capacity assessment should take place or be investigated within the appeal limitation period; (2) it found the total delay was...

April 6, 2021

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C.M. v. Intact Insurance Company (20-001049)

The claimant was involved in a motorcycle accident in 2013. In 2015 she signed a Settlement Disclosure Notice and Full and Final Release settling her claim for accident benefits. The claimant did not have legal representation when she signed the settlement documents. In 2017 the claimant submitted to the insurer an OCF-19 application for determination...

April 3, 2021

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R.O. v. Dominion of Canada Insurance Company (18-009887)

The insurer filed a request for reconsideration in relation to the previous ruling, which determined that s.25 CAT assessments are excluded from the $50,000.00 medical benefits limit. The insurer argued that Tribunal erred in law or fact and requested that the previous decision be set aside. The insurer argued that the Tribunal had erred in...

April 1, 2021

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M.A. v. Portage La Prairie Mutual Insurance Company (18-001837)

The insurer sought reconsideration of a decision in which the Tribunal found that the claimant was entitled to NEBs and a special award of 40%. Adjudicator Grieves dismissed the insurer's request, on the basis that the Tribunal did not make any error of law or fact in rendering its decision. In doing so, she noted...

March 31, 2021

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Laszlo v. Economical Mutual Insurance Company (20-001644)

The claimant sought entitlement to benefits and the parties attended a case conference where the insurer raised the preliminary issue of whether the claimant was statute barred from proceeding with her claim for an IRB pursuant to section 56 of the Schedule. Adjudicator Chakravarti determined that the claimant was statute barred and her appeal was...

March 30, 2021

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Rathakrishnan v. Aviva Insurance Company (19-009539)

The claimant sought entitlement to benefits and the parties attended a case conference where the insurer raised the preliminary issue of whether the claimant was statute barred from proceeding with her claim pursuant to section 56 of the Schedule. Adjudicator Chakravarti found that pursuant to section 56 of the Schedule, the claimant was statute barred...

March 30, 2021

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Kasbar v. Travelers Insurance (19-009400)

A preliminary issues hearing was held to determine whether the claimant was barred from proceeding with a LAT application pursuant to s. 55(1) and s. 32(1) of the SABS for failure to notify the insurer of the circumstances giving rise to a claim for a benefit and/or not applying for a benefit within the times...

March 29, 2021

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P.M. v. Aviva Insurance Canada (18-009518)

The insurer submitted a request for reconsideration arising out of a decision which found that the claimant was entitled to payment of IRBs during a period of section 33 suspension, arguing she had not provided a reasonable explanation for her non-compliance (namely that she believed the insurer could access the information). The insurer argued that...

March 26, 2021

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Degroot v. Security National Insurance Company (20-005980)

The self-employed claimant disputed his entitlement to IRBs. The insurer agreed that the claimant was entitled to IRBs, but argued that the claimant had not provided sufficient evidence to calculate the weekly quantum. Adjudicator Watt held that the claimant had provided sufficient documentation to the insurer, having provided all of the documentation that the CRA...

March 26, 2021

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Cura v. Aviva Insurance Canada (2021 ONSC 2290)

The claimant sought judicial review of the Tribunal's decision that her withdrawal of consent for the IE facility to possess her personal information amounted to IE non-attendance. The claimant's reconsideration request had been dismissed as pre-mature. The Divisional Court dismissed the review, holding that it was premature. Parties are not to appeal or seek judicial...

March 26, 2021

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L.M. v. The Co-operators General Insurance Company (19-003485)

The insurer sought reconsideration of the Tribunal's decision that the claimant was an insured person as a dependent of his mother. Vice Chair Flude dismissed the reconsideration because the Tribunal's decision had not finally disposed of the appeal. Rule 18.1 required that the insurer wait until the matters in dispute were finally disposed of. The...

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Contact Us

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com