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 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...

March 25, 2021

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C.P. v Aviva Insurance Canada (18-004460)

The claimant applied to the LAT seeking a determination that his accident-related impairments were outside of the MIG and entitlement to two treatment plans for medical benefits. A hearing was held in August 2019. Several months later, the LAT was informed that the claimant had passed away. At a subsequent teleconference hearing, the insurer argued...

March 24, 2021

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M.F. v. Belair Insurance Company (18-003847)

The claimant submitted a request for reconsideration arising out of a decision which found that he was not entitled to medical benefits and post-104 week IRBs because the claimant's psychological impairments were not a result of the accident. The claimant's reconsideration request was made on the basis that there was fresh evidence (a new IE...

March 22, 2021

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V.M.L. v. Aviva General Insurance Company (18-001713)

This Request for Reconsideration was filed by the claimant following a decision by the Tribunal that she was statute barred from proceeding with her appeal of the insurer's refusal to pay an IRB and the Tribunal's decision not to extend the limitation period by way of section 7 of the LAT Act. Vice Chair Maedel...

March 19, 2021

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Almayahi v. The Co-Operators General Insurance Company (20-001166)

The claimant sought entitlement to two chiropractic treatment plans and a special award. Adjudicator Grant found that the claimant was entitled to payment for the costs of both treatment plans on the basis that the medical documentation supported his reports of consistent and ongoing pain since the accident, and that the goals of pain reduction,...

March 18, 2021

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Raveenthiran v. Aviva Insurance Canada (19-014703)

The preliminary issue in this matter was whether the claimant was statute barred from proceeding with her claim pursuant to section 56 of the Schedule. Adjudicator Lake found that the claim for IRBs could proceed as it was not barred under s. 56 of the Schedule. Adjudicator Lake concluded that the insurer did not deliver...

March 17, 2021

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Butler v. Allstate Insurance (19-013444)

The claimant applied to the LAT disputing entitlement to attendant care benefits and medical benefits. The dispute proceeded by written hearing. Adjudicator Lake held that the claimant was not entitled to ACBs for the three periods claimed. For the first period, Adjudicator Lake dismissed the claim as the claimant sought benefits prior to submission of...

March 17, 2021

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J.T. v. Aviva Insurance Company (18-003238)

The claimant submitted a request for reconsideration arising out of a decision which granted entitlement to some benefits, interest, and an award of 25 percent of the disputed amounts for three treatment plans unreasonably withheld by the insurer. The decision determined the cost of the withheld treatment plans and the percentage to be applied, but...

March 16, 2021

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Patchett v. Optimum Insurance Company (19-008902)

The claimant sought reconsideration of a LAT decision denying that she met the catastrophic impairment definition because her accident-related impairment did not result in a permanent mobility score on the Spinal Cord Independence Measure III ("SCIM"). Adjudicator Boyce dismissed the claimant's request for reconsideration. The issue in this case was whether the claimant's mobility impairment...

March 16, 2021

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Viran v. Aviva General Insurance Company (19-008488)

The claimant sought entitlement to physical treatment and various assessments, as well as a special award. Adjudicator Grant determined that the claimant was entitled to the disputed physical treatment plan, finding that the claimant's pre and post-accident visit history with her family doctor was indicative of significant and ongoing accident-related pain complaints and noting that...

March 12, 2021

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A.W.A. v Certas Home and Auto Insurance (18-007207)

The claimant sought reconsideration of a LAT decision denying the $24,000 cost of catastrophic impairment assessments. Adjudicator Gosio dismissed the claimant's request for reconsideration. Adjudicator Gosio agreed with the claimant that the hearing adjudicator failed to consider that the OCF-18 for CAT assessments concerned both Criterion 7 and 8. Adjudicator Gosio held that irrespective of...

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Contact Us

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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