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.

October 18, 2023

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Mansuri v. Dominion of Canada General Insurance Company (2023 ONSC 5764)

The claimants appealed the Tribunal's decision permitting the insurer to use the same counsel and same adjuster on three claims made by three relatives of the same household. The claimants argued that there was a conflict because the insurer and its counsel could intermingle the claims materials. The Court dismissed the appeal, finding that it...

October 13, 2023

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Tagoe v. The Personal Insurance Company (2023 ONSC 5715)

The claimant appealed the Tribunal's decision that the limitation period barred his IRB claim. He returned to work one day after the accident. The insurer denied the claim for IRBs at that point in May 2016. The claimant then went off work 16 months later and required hip surgery. He applied for IRBs in January...

September 25, 2023

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Biniaz-Sarabi v. Gore Mutual Insurance Company (2023 ONSC 5379)

The claimant appealed the Tribunal's decision dismissing her claims for IRBs, ACBs, and various medical benefits. Her submissions focused on the dissatisfaction with the manner the insurer managed the claim. The claimant failed to point to any error of law on the part of the Tribunal. The adjudicator made every reasonable effort to ensure the...

September 20, 2023

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Akinyimide v. Economical Mutual Insurance Company (2023 ONSC 5272)

The claimant appealed the Tribunal's decision that section 31 barred her claim for IRBs. The claimant reported to her insurer that she lived in Windsor, rather than Toronto, when obtaining her auto insurance policy. The misrepresentation resulted in lower premiums. She was involved in an accident in October 2017. The insurer learned of the misrepresentation...

September 13, 2023

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Tyner v. Certas Home and Auto Insurance Company (2023 ONSC 5179)

The claimant appealed the Tribunal's decision regarding a catastrophic impairment, and various medical benefits claims. The claimant sought reconsideration of the decision, which was outstanding at the time of this appeal. The Court dismissed the appeal, holding that the reconsideration decision would be the final order, and that prior to the reconsideration decision, the appeal...

September 11, 2023

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Joaquim v. Intact Insurance Company (2023 ONSC 5120)

The claimant appealed the Tribunal's decision that she was failed to attend an IE in relation to a claimed prescription expense. The claimant argued that the SABS does not permit an IE in relation to prescriptions. The Divisional Court granted the appeal, holding that only items required to be submitted on a treatment plan could...

August 2, 2023

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Kellerman-Bernard v. Unica Insurance Company (2023 ONSC 4423)

The claimant appealed the Tribunal's decision that she could not receive a catastrophic impairment designation because she was not involved in the subject accident. The claimant's son was significantly injured in an accident, and the claimant suffered psychological injuries. The Tribunal held that only persons involved in an accident could apply for a catastrophic impairment...

July 26, 2023

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Milanovic v. Intact Insurance Company (21-008566)

The insurer argued that pursuant to s. 55 of the SABS the claimant was barred from proceeding with a claim for catastrophic impairment as he did not submit to an IE. The adjudicator concluded that the claimant was not barred. The insurer’s notices were argued to not provide medical and other reasons pursuant to section...

July 26, 2023

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Kopylets v. Primmum Insurance Company (21-015682)

The claimant was riding her bicycle with other cyclists. When she made a right turn, the wheels of her bicycle lost traction on a fluid deposit on the asphalt surface, causing her to fall and suffer injuries. The parties agreed that the issue in dispute was whether the claimant was involved in an “accident” as...

July 25, 2023

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Bewes v. TD General Insurance Company (22-009538)

A preliminary issue hearing was ordered at the Case Conference to determine if the claimant was barred from pursing her claim for IRBs as she did not submit an OCF-3 within 104 weeks of the accident. The claimant's accident occurred on September 15, 2020. The claimant submitted an OCF-2 on October 29, 2020. TD responded...

July 25, 2023

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C. B., T.G.B. and B.G.B v Belair Direct Insurance Company (22-002265)

The issue revolved around the family of the accident victim, JG, who was deemed psychologically catastrophically impaired as a result of witnessing her friend being struck and killed by a vehicle. JG's spouse and children applied for accident benefits claiming they had suffered psychological injury as a result of JG's psychological impairments. The claimants applied...

July 25, 2023

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Abdi v. TD General Insurance Company (2023 ONSC 3536)

The claimant appealed the Tribunal's decision that he did not suffer a catastrophic impairment, as he did not meet the Extended Glasgow Outcome Scale ("GOS-E"). In particular, the adjudicator preferred the assessments of the insurer which took place almost 24 months after the accident, rather than the assessments of the claimant which took place around...

July 18, 2023

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D.I. v. TD General Insurance Company (19-013437)

The claimant was a minor whose father was involved in an motor vehicle accident. The claimant was autistic and was largely cared for by his mother. The father and mother separated years prior to the accident. The father was a listed driver on his mother-in-law's insurance policy with TD. The claimant applied for accident benefits...

July 14, 2023

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Rawal v. Economical Insurance (21-007975)

The claimant sought entitlement to IRBs, medical/rehabilitation benefits, a psychological assessment, and the cost of an accountant's report. The respondent denied the claims for medical and rehabilitation benefits because it determined that the claimant's injuries fell within the MIG. Adjudicator Neilson accepted that the claimant sustained a psychological impairment as a result of the accident...

July 11, 2023

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Bashiruddin v. TD General Insurance Company (21-008274)

The claimant sought entitlement to a special award and interest on an approved OCF-18 for a psychological assessment. The claimant was involved in an automobile accident in September 2018. In March 2020, the respondent contacted the claimant about scheduling section 44 IE assessments to determine her eligibility to receive benefits. These assessments were rescheduled several...

July 4, 2023

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Rathbone v. Co-operators General Insurance Company (22-009104)

The claimant was stopped at a drive-thru window at Tim Hortons. His vehicle was in drive mode. As he transferred the coffee cup, the lid came off and the upper brim of the cup collapsed inwards, spilling coffee over the sides of the cup and onto his lap. The respondent raised a preliminary issue, taking...

June 30, 2023

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Luluquisin v. Aviva Insurance Company of Canada (2023 ONSC 3912)

The claimant sought judicial review of the Tribunal's decision regarding the quantum of ACBs awarded, and entitlement to various medical benefits. The insurer argued that the decision should have been appealed, rather than the subject of judicial review. The Court agreed with the insurer, holding that judicial review was not warranted and that the Court...

June 29, 2023

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Shaver v. Onlia Insurance Company

The claimant applied to the LAT seeking entitlement to accident benefits. He was involved in a motor vehicle accident as a pedestrian. The main issue was whether the claimant was barred from proceeding to a hearing as he failed to notify the insurer of the circumstances giving rise to a claim for benefits no later...

June 27, 2023

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L.D. v. Gore Mutual Insurance Company (18-011978)

The claimant sought entitlement to IRBs and a special award relating to a three year prior where she did not attend IEs. The Tribunal dismissed the claim, holding that the insurer had given proper IE notices, and that the claimant did not have a reasonable explanation for failing to attend the IEs. The claimant raised...

June 23, 2023

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[K.M.] v. Aviva Insurance Canada (22-000554)

The claimant sought benefits, including increased monthly rental costs, home renovations and a wheelchair accessible vehicle, after sustaining a catastrophic impairment. Prior to the hearing, the insurer approved all treatment plans at issue, leaving only a special award in dispute. The claimant argued that they were entitled to a special award as the insurers adjusting...

June 23, 2023

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Doran v Gore Mutual Insurance Company (20-013924)

The claimant sustained a CAT impairment and sought ACBs from the insurer. The insurer initially provided ACBs at $6,000 per month, but benefits were reduced to $4,339.71 and later cut to $1,040.10, based on the determination that she no longer required basic supervisory care and mobility assistance. The claimant disputed these reductions. The LAT ruled...

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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