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.

Search

Generic filters

May 24, 2019

/

tgp-admin

D.M. v. Aviva Insurance (17-003463)

The insurer sought reconsideration of the Tribunal's decision to award ACBs beyond the 104 week mark despite the claimant not being designated catastrophically impaired, and the decision to deem the attendant care services incurred. Adjudicator Boyce granted the reconsideration. He held that the Tribunal made a significant error of law in awarding ACBs beyond the...

May 23, 2019

/

tgp-admin

T.C. v. Aviva Insurance Canada (17-008107)

The claimant sought reconsideration of the Tribunal's decision that she was not entitled to IRBs. Adjudicator Boyce dismissed the reconsideration request. He held that the claimant's arguments amounted to an attempt to re-argue the case and reweigh the evidence and credibility, which was not the purpose of a reconsideration. He also held that a new...

May 23, 2019

/

tgp-admin

K.B. v. Aviva General Insurance Company (17-009088)

The claimant sought entitlement to NEBs. Adjudicator Punyarthi dismissed the claim. He held that the claimant did not meet the "complete inability" test, and that the evidence submitted did not provide an in-depth assessment of the claimant's pre-accident and post-accident activities or how he was practically prevented from engaging in the activities that were most...

May 23, 2019

/

tgp-admin

L.K.C. v. Unifund Assurance Company (18-004346)

The insurer sought reconsideration of the Tribunal's order to produce adjusting log notes. Adjudicator Marzinotto dismissed the reconsideration request. She held that the Tribunal did not make a significant error of law, and that the log notes were relevant to the issues in dispute. She also noted that there was no legal requirement that a...

May 17, 2019

/

tgp-admin

C.D. v. Aviva General Insurance (17-005825)

The Tribunal had awarded the claimant all claimed medical benefits in her application, and a 25 percent special award. The insurer sought reconsideration, arguing that it had paid amounts to the clinics for the medical benefits, so that any payments to the claimant was double recovery. The insurer also argued that the special award was...

May 16, 2019

/

tgp-admin

T.K. v. Allstate Insurance (18-007113)

The claimant sought an order for interim benefits pending the LAT hearing. The insurer argued that the LAT did not have jurisdiction to award interim benefits. Adjudicator Letourneau agreed with the insurer and held that he did not have jurisdiction to award interim benefits. When read together, none of the Insurance Act, the Statutory Powers...

May 16, 2019

/

tgp-admin

A.P. v. Coachman Insurance Company (17-004906)

The Tribunal had awarded the claimant IRBs for a specific quantum and specific time period; the Tribunal also awarded interest on medical benefits. The insurer sought reconsideration, arguing that the decision did not accurately reflect the timeframe for payment of IRBs and when interest became payable. Adjudicator Lester partially granted the reconsideration request. She held...

May 16, 2019

/

tgp-admin

J.L. v. Wawanesa Mutual Insurance Company (18-000766)

The claimant sought reconsideration of the Tribunal's decision that he did not suffer a catastrophic impairment under the Glasgow Coma Scale. He argued that the Tribunal should have admitted video evidence of the paramedic administering the GCS. Adjudicator Boyce agreed with the Tribunal that the video had limited probative value and was unlikely to change...

May 16, 2019

/

tgp-admin

D.M. v. Wawanesa Mutual Insurance Company (18-003314)

The claimant was catastrophically impaired as a result of a motorcycle accident. He sought entitlement to $6,000 per month in ACBs and entitlement to further physiotherapy. Adjudicator Hines awarded $3,047.29 per month in ACBs. The primary dispute was whether the claimant required 24/7 care. The adjudicator concluded that the claimant did not require 24/7 care....

May 15, 2019

/

tgp-admin

A.R. v. Certas Direct Insurance Company (18-005035)

The claimant sought entitlement to IRBs; the insurer argued that the claimant failed to attend an IE. Adjudicator Johal concluded that the claimant was barred from proceeding with the LAT dispute until attending an IE. Although the claimant was justified in not attending the initially scheduled IE based on a note from his family doctor,...

May 15, 2019

/

tgp-admin

M.G. v. Intact Insurance Company (17-008078)

The only issue in dispute regarded payment of an accounting report. The insurer had requested an oral hearing; the Tribunal ordered that the matter be heard in writing. The insurer sought reconsideration. Adjudicator Jovanovich held that the Tribunal had not violated the rules of natural justice. The Tribunal had considered the "efficient, proportional, and timely...

May 15, 2019

/

tgp-admin

F.C. v. Intact Insurance Company (18-005079)

The claimant had applied to the Tribunal for accident benefits, and commenced an action for property damage in the Superior Court. The insurer alleged that the claimant had committed material misrepresentations, and sought a stay of the LAT proceedings until the Superior Court decision was rendered or a preliminary hearing addressing the material misrepresentations. The...

May 14, 2019

/

tgp-admin

S.M. v. Aviva General Insurance Company (17-008818)

Vice-Chair Helt dismissed the insurer's request for reconsideration. The insurer alleged that the LAT violated the rules of natural justice and procedural fairness and made significant errors of law. The parties had agreed upon a document exchange deadline. The claimant brought a motion following the deadline, requesting an opportunity to file an affidavit. The LAT...

May 14, 2019

/

tgp-admin

M.K. v. Aviva Insurance Canada (18-001128)

The claimant sought entitlement to the balance of a partially approved psychological assessment. Adjudicator Punyarthi held that the claimant was not entitled to the remaining balance as there was no evidence substantiating the claimant's entitlement. The adjudicator specifically noted that the treatment plan at issue was vague and unparticularized, and there was no justification as...

May 14, 2019

/

tgp-admin

C.S. v. Certas Home and Auto Insurance (18-003463)

The claimant was injured in an icy parking lot. She was a few feet from her vehicle when she slipped and fell. She applied for accident benefits. The insurer denied coverage on the basis that the incident was not an "accident" under the SABS. Adjudicator Ferguson concluded that the facts of loss were not an...

May 14, 2019

/

tgp-admin

J.M. v. Aviva General Insurance (17-007215)

The insurer sought reconsideration of the Tribunal's decision that catastrophic impairment assessments are payable outside of the medical benefits limits. Vice Chair Flude held that the Tribunal's decision did not contain a significant error of law, and was correct. He concluded that earlier FSCO decisions addressing the same issue were correct, and that catastrophic impairment...

May 14, 2019

/

tgp-admin

P.K. v. Certas Direct Insurance Company (18-003184)

The claimant twice adjourned a hearing, and then failed to attend the rescheduled hearing. The insurer sought a dismissal of the application. Adjudicator Parish granted the dismissal on the basis the claimant had abandoned the claim.

May 13, 2019

/

tgp-admin

A.A. v. Unifund Assurance Company (18-008999)

The insurer raised a preliminary issue and argued that the claimant's attendant-care benefit appeal was statute-barred. Adjudicator Ferguson held that the ACB claim was not barred, as the insurer had not provided the claimant with an unequivocal denial at least 2 years prior to the appeal. In November 2012, the insurer initially advised the claimant...

May 13, 2019

/

tgp-admin

W.H. v. Allstate Insurance (18-004037)

The claimant sought entitlement to three treatment plans for further physical therapy, assistive devices, and a chronic pain treatment program. Adjudicator Boyce awarded some of the assistive devices and denied the remainder of the claim. He held further physical therapy was not reasonable and necessary for the claimant's impairment, and that the proposed chronic pain...

May 10, 2019

/

tgp-admin

N.F. v. North Blenheim Mutual Insurance Company (16-002606)

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

May 10, 2019

/

tgp-admin

A.F. v. North Blenheim Mutual Insurance Company (16-002336)

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

Contact Us

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

416.507.1850

smilne@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP Disclaimer | Privacy Policy | Statement of Principles

Powered by Crow & Pitcher

Subscribe to get TGP’s case summaries straight to your inbox

Subscribe to get TGP’s case summaries straight to your inbox

Contact Us

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

416.507.1850

smilne@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP