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.

February 26, 2021

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Branden v. Co-operators General Insurance Company (19-008343)

The insurer sought reconsideration of the Tribunal's decision that it was not entitled to deduct a long-term disability settlement from IRBs; the claimant sought reconsideration of the Tribunal's decision that a special award was not payable. Vice Chair Boyce rejected both reconsideration requests. He found no error of law relating to the Tribunal's conclusions about...

February 26, 2021

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tgp-admin

Beaudin v. Travelers Insurance Company of Canada (2021 ONSC 1389)

The insurer appealed the Tribunal's decision that the dirt bike involved in the accident was an automobile for the purposes of the SABS. The Tribunal had concluded that the dirt bike was required to be insured under the Off-Road Vehicles Act and was not exempt from insurance through the regulation that allowed off-road vehicles to...

February 25, 2021

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tgp-admin

Chance-Guppy v. Aviva General Insurance Company (19-004820)

The insurer requested a reconsideration of a hearing decision in which the claimant was found entitled to NEBs with interest. The insurer argued, among other things, that the LAT erred by ordering payment of NEBs beyond the 104-week mark and erred in its application of the Heath test by not requiring the claimant to present...

February 25, 2021

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tgp-admin

Rochford v. Unifund Assurance Company (19-007743)

The claimant was assaulted when he exited his vehicle while attempting to park. A written preliminary issues hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The claimant submitted that he was assaulted when he initially exited his vehicle to speak to people...

February 25, 2021

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tgp-admin

Security National Insurance Company v. Balgobin (20-003118)

The insurer requested repayment as a result of IRB payments made in error due to the claimant's failure to notify the insurer that she had already returned to work. The claimant did not participate in the hearing. Vice Chair Boyce found that the insurer acted diligently upon receipt of information that the claimant was no...

February 25, 2021

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tgp-admin

Jevco Insurance v. Owusu-Achiaw (19-012474)

The insurer requested repayment as a result of IRB payments made based on the claimant's material misrepresentation over his address and the resulting insurance premiums. The claimant did not participate in the hearing. Vice Chair Boyce found that the claimant made a willful misrepresentation in failing to disclose his correct address in order to attract...

February 25, 2021

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tgp-admin

Canavan v. Unifund Assurance Company (19-011366)

The claimant submitted his application for accident benefits more than two years after the accident. The insurer argued that the application was late and that the claimant did not have a reasonable excuse for the lateness, and that the claim was therefore barred. Adjudicator Chakravarti agreed that the claimant did not comply with the timelines...

February 24, 2021

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

The insurer filed a request for reconsideration of a LAT hearing decision, in which the adjudicator found that the claimant was entitled to attendant care benefits at a reduced rate and medical expenses. The insurer submitted that the adjudicator erred in making the inference that because the claimant met the threshold for catastrophic impairment, she...

February 23, 2021

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S.R. v Traders General Insurance Company (17-004556)

The claimant filed a request for reconsideration of a LAT hearing decision, in which the adjudicator found that the claimant was entitled to pre-104 IRBs but was not entitled to post-104 IRBs. The claimant argued that the adjudicator had made errors in fact and law, including incorrectly applying the test for IRBs. In the hearing...

February 23, 2021

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Clements v. The Co-operators Group Limited (19-009258)

The claimant witnessed the aftermath of an accident in October 2016 involving his brother, partner, and three children. He applied for accident benefits two years later. The insurer argued that the claimant's application was barred as being late without reasonable explanation. Adjudicator Grant agreed with the insurer and dismissed the claim. The claimant argued that...

February 22, 2021

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tgp-admin

Duncan v. The Co-operators General Insurance Company (19-014310)

A written preliminary issue hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The parties agreed that the claimant sustained injuries when he slipped and fell after exiting his vehicle. The claimant was completely out of the vehicle and had walked approximately 10...

February 22, 2021

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tgp-admin

Khamis v. Unifund Assurance Company (19-013760)

A written hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The parties agreed that the claimant sustained injuries when he slipped on ice as he was exiting his vehicle and fell to the ground on his left side. The insurer disputed the...

February 19, 2021

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Lindo v. Echelon General Insurance Company (19-014520)

A written preliminary issue hearing was held to determine whether the claimant was involved in an accident as defined in s. 3(1) of the SABS. The claimant claimed she was involved in an accident when her vehicle was side swiped by another vehicle, causing her injuries and damaging her vehicle. The insurer submitted that the...

February 18, 2021

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D.L. v. Aviva General Insurance Company (19-000651)

The claimant sought entitlement to medical benefits, a social work assessment, an OCF-3 expense, and interest. Adjudicator Boyce concluded that the claimant was entitled to the three medical benefits, but not the assessment or expense. The insurer agreed to fund these treatment plans subject to a ruling with respect to the amounts proposed in excess...

February 17, 2021

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Aviva General Insurance v. E.R. (19-001839)

The insurer requested repayment as a result of IRB payments made in error, as it was unaware that the claimant had returned to work until it received the information in a section 44 IE report. The claimant argued that it was prejudicial for his own insurer to penalize him as a result of their error....

February 16, 2021

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tgp-admin

Spence v. Aviva Insurance Company of Canada (19-013457)

The claimant and insurer disagreed over the deduction of EI sickness benefits from IRBs. Vice Chair Boyce held that EI sickness benefits were not deductible from IRBs because they were not considered "gross employment income". He distinguished cases which permitted the deduction of EI maternity benefits - which were received because a person is employed...

February 12, 2021

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tgp-admin

Baldinelli v. Aviva Insurance Company (19-013752)

The claimant was injured in an incident that involved a series of assaults, resulting in physical injuries. The facts of the case are unusual: The claimant heard a commotion on his street. He got in his vehicle and drove down his driveway where he was met by two assailants. The claimant opened the driver's side...

February 11, 2021

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Jamon v. The Co-operators (19-006256)

The claimant sought entitlement to IRBs and various medical/rehabilitation benefits, including an attendant care assessment and functional abilities assessment. With respect to IRBs, Adjudicator Parish found that the claimant had proven on a balance of probabilities that she was substantially unable to perform the essential tasks of her pre-accident employment as a supervisor at Dairy...

February 11, 2021

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tgp-admin

Aviva General Insurance Company v. Ghandahari (19-009382)

The insurer requested repayment as a result of benefit payments made based on the claimant's wilful misrepresentation when she failed to disclose that the accident occurred during the course of her employment and she made a claim for benefits from the WSIB. The claimant did not participate in the hearing. Adjudicator Chakravarti agreed with the...

February 10, 2021

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Alakoozi v. ACE INA Insurance (20-000516)

The claimant sought entitlement to benefits following an accident that occurred on December 15, 2016. At the case conference, the insurer raised the preliminary issue that the claimant was statute-barred from proceeding with his claim under s. 56 of the Schedule because he failed to appeal its valid denial within the two-year limitation period. Adjudicator...

February 10, 2021

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Mohammad v. The Dominion of Canada General Insurance Company (20-000007)

The claimant sought entitlement to benefits following an accident that occurred on August 28, 2015. At the case conference, the insurer raised the preliminary issue that the claimant was statute-barred from proceeding with his claim under s. 56 of the Schedule because he failed to appeal its valid denial within the two-year limitation period. A...

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Contact Us

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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