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 9, 2021

/

tgp-admin

Seepersaud v. Allstate Insurance (20-000400)

The claimant sought a special award due to the insurer's unreasonable delay in paying his IRB. Vice Chair Boyce found that the evidence demonstrated that the insurer withheld and delayed the payment of the claimant's IRB claim for over one year of his eligibility, despite having all of the documentation reasonably required to initiate and...

February 8, 2021

/

tgp-admin

Sheriffe v. Aviva Insurance Company of Canada (19-009684)

This was a preliminary motion decision on the claimant's request for production of adjuster's log notes beyond the date of the LAT application, and the insurer's request for production of a 2010 AB file for a previous accident. Adjudicator Maedel ordered that the insurer produce the log notes beyond the date of the LAT application,...

February 8, 2021

/

tgp-admin

S.P. v. Aviva General Insurance Company (18-008876)

The claimant sought reconsideration of a LAT dispute denying her entitlement to IRBs and medical benefits. The claimant was represented by counsel at the hearing and with respect to the reconsideration application. Adjudicator Boyce noted that the claimant's reconsideration submissions were 24 pages single spaced and made sweeping accusations that the adjudicator denied her procedural...

February 8, 2021

/

tgp-admin

Khosla v. TD General Insurance Company (19-010508)

The claimant applied to the LAT disputing her entitlement to a chiropractic treatment plan. The issue in this dispute was the application of sections 38(5) and (6), and the MIG. The insurer denied the treatment plan in accordance with section 38(5) on the basis that the claimant was being treated within the MIG. Later, the...

February 5, 2021

/

tgp-admin

Cox v. Wawanesa Mutual Insurance Company (19-012281)

The claimant was involved in a serious motor vehicle accident in 2014. She received IRBs for four years, until they were terminated based on multidisciplinary s. 44 opinions. The claimant applied to the LAT seeking entitlement to post-104 week income replacement benefits and a special award. As a preliminary issue, the claimant requested that the...

February 5, 2021

/

tgp-admin

Duah v. Wawanesa Mutual Insurance Company (19-006610)

The claimant was injured when he slipped and fell on ice while attempting to retrieve his car key from his bag. He suffered a displaced spiral fracture of his fibula. The claimant applied to the insurer for accident benefits. The insurer denied that an accident occurred. The claimant applied to the LAT and the matter...

February 4, 2021

/

tgp-admin

Z.R. v. Gore Mutual Insurance (18-000017)

The insurer sought reconsideration of the Tribunal's decision that the claimant suffered a catastrophic impairment, and that he was entitled to NEBs. Adjudicator Hines dismissed the reconsideration. She accepted that the Tribunal ought not to have counted 3 percent WPI for medication use because the medication did not have the effect of cancelling out the...

February 3, 2021

/

tgp-admin

J.J. v. Economical Insurance Company (19-003835)

A 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 submitted that he was riding on the back of an ATV down a laneway on the way to his home when he fell off the back and suffered a...

February 3, 2021

/

tgp-admin

Escobar v. The Guarantee Company of North America (20-000259)

The claimant sought entitlement to two treatment plans, including a medical benefit for dental treatment and a rehabilitation benefit for a hot tub. The claimant also sought a special award. Adjudicator Grant found that the claimant was entitled to the OCF-18 for dental treatment, but was not entitled to the OCF-18 for a hot tub,...

February 3, 2021

/

tgp-admin

Shih v. Economical Insurance (20-005669)

The claimant sought entitlement to Income Replacement benefits and three treatment plans. The insurer raised a limitation defence in accordance with s. 56 of the Schedule. The insurer argued that the claimant failed to challenge the denial of the IRB and two of the three treatment plans within the two-year limitation period. Adjudicator Mazerolle found...

February 1, 2021

/

tgp-admin

Corpuz v. Aviva General Insurance (19-014198)

The claimant applied to the LAT seeking entitlement to medical benefits proposed in two treatment plans. The insurer sought an award of costs in the amount of $1,000.00 on the grounds that the claimant acted vexatiously and in bad faith in the proceeding. The insurer argued that the claimant had misled the LAT by misrepresenting...

February 1, 2021

/

tgp-admin

Jeyakumar v. Aviva General Insurance (19-010878)

The claimant applied to the LAT seeking entitlement to pre-104 week income replacement benefits. The claimant had returned to work at the time of the hearing and was seeking entitlement to IRBs for the period before he returned to work. Adjudicator Boyce found that the claimant failed to demonstrate that he had a substantial inability...

January 29, 2021

/

tgp-admin

McQueen v. Aviva Insurance Canada (19-011429)

A preliminary issue hearing was held to determine whether the claimant's application was statute-barred from appealing the denial of IRBs and medical benefits because the claimant failed to commence her appeal within two years. Adjudicator Paluch found that the claimant was statute barred from proceeding with her claim for IRBs and medical benefits . In...

January 29, 2021

/

tgp-admin

Campbell v. Aviva Insurance Company (19-012095)

The claimant sought entitlement to three treatment plans for chiropractic treatment. Adjudicator Lake found that the claimant was entitled to all three of the treatment plans, plus interest as a result of the insurer's failure to comply with section 38(8). The claimant cited the decision of T.F. v. Peel Mutual Insurance Company, stating that an...

January 29, 2021

/

tgp-admin

Iqbal v. Gore Mutual Insurance Company (20-005901)

A preliminary issue hearing was held to determine whether the claimant was disentitled to accident benefits because he did not have a reasonable explanation for providing the insurer with notice of the accident and/or failing to apply for benefits within the time limits imposed by section 32(1) of the SABS. Adjudicator Lake held that the...

January 29, 2021

/

tgp-admin

Aviva General Insurance Company v. Gurung (20-000592)

The insurer sought repayment of all IRBs paid to the claimant, totaling $36,456, based on the claimant failing to notify the insurer that she was earning income as the owner of a restaurant. The insurer argued that it was entitled to repayment of more than one year of IRBs because the overpayment was due to...

January 28, 2021

/

tgp-admin

Jama v. Unifund (20-005328)

The insurer brought a preliminary issue hearing seeking an order that the claimant was not entitled to receive an IRB pursuant to section 57, which outlines an insured person's responsibility to pursue reasonable, necessary, and available forms of treatment if the insured person continues to receive a weekly benefit, such as an IRB. Adjudicator Mazerolle...

January 28, 2021

/

tgp-admin

Zhao v. Allstate Canada (20-000134)

The claimant filed a LAT application seeking entitlement to an attendant care assessment, various other treatment plans, and an award under Regulation 664. The claimant's hearing submissions noted that the dispute over medical benefits other than the attendant care assessment were resolved prior to the hearing. While the case conference order referenced a claim for...

January 26, 2021

/

tgp-admin

G.W.R. v. Commonwell Mutual Insurance (19-002647)

The claimant applied to the LAT disputing entitlement to four treatment plans. The insurer raised a preliminary issue that the disputed treatment plans were barred from litigation under section 55 of the SABS due to the claimant's failure to attend section 44 IE assessments to address the disputed issues without a reasonable explanation. In response,...

January 26, 2021

/

tgp-admin

Terrio v. Aviva General Insurance (20-000524)

The claimant disputed entitlement to NEBs. The claimant had a number of pre-existing health conditions. The claimant's affidavit indicated that she was independent prior to the accident, had managed her various medical conditions well, and was looking for employment. Adjudicator Farlam found that the documentary evidence did not prove the claimant's position. The medical records...

January 22, 2021

/

tgp-admin

Hastings v. Royal Sun Alliance insurance (20-001485)

The claimant sought entitlement to two treatment plans, including chiropractic services and physiotherapy. Adjudicator Mazerolle found that the claimant was not entitled to payment for either of the disputed treatment plans. The claimant alleged that the treatment plans were not denied within the ten-day timeline required by section 38(8) and that the insurer relied on...

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

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

Powered by Crow & Pitcher

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com