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.

November 30, 2020

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Williams v. Wawanesa Mutual Insurance Company (19-007941)

The insurer sought an order that the claimant's application for IRBs was time barred since it was commenced more than two years after the denial. The insurer had written to the claimant and her legal representative of the stoppage, provided the claimant with a copy of the IE report and advised of the right to...

November 27, 2020

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L.L.B. v. Intact Insurance Company (17-003125)

This is a decision over the definition of "accident" in the SABS. This case has a long history. The claimant and the insurer disagreed over whether an accident occurred. The claimant was working as a crew member of a television production company in downtown Toronto. Her job was to keep watch over three dedicated parking...

November 27, 2020

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Mann v. Aviva Insurance Company (19-007477)

The claimant sought entitlement to a psychological assessment and a chronic pain assessment, plus a special award. As a preliminary matter, the parties' submissions refer to a disagreement over whether the psychological assessment was withdrawn with prejudice by the claimant at a previous case conference in an earlier Tribunal matter. Adjudicator Maleki-Yazdi found that the...

November 26, 2020

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Patchett v. Optimum Insurance Company (19-008902)

The claimant applied for a catastrophic impairment under Criterion 2(iii) of the new definitions, requiring a SCIM score of five or less on an indoor mobility test. The claimant's score was below five shortly following the accident when she was recovering from fractures in her extremities. However, the score was above five after a number...

November 25, 2020

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Ai v. Intact Insurance Company (19-005110)

The claimant requested reconsideration of the Tribunal's previous decision barring his LAT Application for refusal to attend IEs. The claimant alleged that Vice-Chair Farlam did not properly interpret the SABS, that the statutory notice requirements in the IE notice letters was not met, and that the IEs should have proceeded by way of paper review...

November 25, 2020

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B.L.J. v. The Co-Operators Company (18-012005)

The claimant applied to the LAT seeking entitlement to medical benefits, IRBs, and ACBs. Prior to the accident, the claimant worked full-time at a restaurant. After the accident, she was off work for several months before starting a volunteer position at a residence for assisted living that transitioned into a part-time job. She continued to...

November 25, 2020

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Aviva General Insurance Company v. Muthusamythevar (19-009392)

The insurer applied to the LAT seeking repayment of an overpayment of IRBs made as a result of wilful misrepresentation. Adjudicator Boyce found that the insured failed to notify the insurer when he returned to full-time work, and he continued to collect IRB payments while working full time. Adjudicator Boyce agreed with previous LAT decisions...

November 24, 2020

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Bhullar v. TD Insurance Meloche Monnex (19-010667)

The claimant sought entitlement to two treatment plans for chiropractic services, massage therapy, and physiotherapy. The insurer submitted that it was not liable to pay either treatment plan in dispute because neither were signed by the health care provider and the claimant as required by section 38(3). The claimant argued that the first time the...

November 23, 2020

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R.M. v. CAA Insurance (19-003499)

The insurer sought an order barring the claimant from proceeding with her application due to non-compliance with the limitation period. The insurer had denied further payment of NEBs by way of letter dated October 4, 2016, which was mailed to the claimant and faxed to her counsel. The claimant applied to the Tribunal on November...

November 19, 2020

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D.Y. v. Aviva General Insurance (18-011171)

The insurer sought reconsideration of the Tribunal's decision awarding payment of non-earner benefits, concussion management treatment and ordering a special award. Vice Chair Trojek granted the insurer's request for reconsideration in part. With respect to the concussion management treatment, Vice Chair Trojek noted that the Tribunal made an error of law in not considering whether...

November 19, 2020

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R.B. v. Aviva Insurance Company of Canada (18-011209)

The insurer requested reconsideration of a decision that found the claimant was not precluded from applying to the LAT for failure to attend IEs. The LAT found in its initial decision the insurer's IE notices for attendant care and psychological assessments did not comply with the SABS because it did not provide sufficient medical and...

November 18, 2020

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R.K. v. Aviva Insurance Canada (17-006866 and 17-006651)

The insurer sought reconsideration of the Tribunal's decision regarding a special award of $1,500 on ACBs on each of two claims which were granted due to unreasonably withheld or delayed payments. The insurer agreed with the quantum of ACBs, but requested that the Tribunal cancel the $1,500 award. The special award had been granted because...

November 18, 2020

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M.I.A. v. Aviva General Insurance (19-000993)

The claimant disputed entitlement to eleven different treatment plans for various therapies, assessments and CAT assessments, interest and a special award. The claimant had a notable history of chronic pain in the lower back, a failed back surgery, migraines, and used a cane. The claimant argued that the treatments and assessments were reasonable and necessary...

November 17, 2020

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A.C.G. v. Aviva Insurance Company (19-004820)

The claimant sought entitlement to NEB, physiotherapy treatment, and a chronic pain assessment. Vice Chair McGee found that the claimant sustained an impairment that continuously prevented her from engaging in substantially all of the activities in which she ordinarily engaged before the accident. Vice Chair McGee assigned greater weight to the activities that the claimant...

November 12, 2020

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J.T. v. TD General Insurance Company (19-003389)

The claimant filed a request for reconsideration to dispute the finding that he was not entitled to interest, an award, or costs related to an approved treatment plan. The request for reconsideration was denied. Adjudicator Grant found that the LAT had not made a significant error of fact or law in the hearing decision. He...

November 12, 2020

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Thompson v. Aviva Canada Inc. (19-005493)

A preliminary issue hearing was brought by the insurer for an order barring the claimant from proceeding with an application for IRBs due to the expiration of the limitation period. The insurer had notified the claimant on November 8, 2016 of stoppage of IRBs effective November 22, 2016 per IEs. The claimant requested payment on...

November 12, 2020

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J.T. v. TD General Insurance Company (19-003389)

The claimant filed a request for reconsideration to dispute the finding that he was not entitled to interest, an award, or costs related to an approved treatment plan. The request for reconsideration was denied. Adjudicator Grant found that the LAT had not made a significant error of fact or law in the hearing decision. He...

November 11, 2020

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P.W. v. Aviva Insurance Canada (18-000854)

Both the claimant and the insurer sought reconsideration of the Tribunal's decision which found that the claimant was not entitled to an income replacement benefit but was entitled to an examination expense for an attendant care assessment. Adjudicator Gosio dismissed the claimant's request for reconsideration, but granted the insurer's request for reconsideration by ordering that...

November 11, 2020

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M.G. v. Aviva General Insurance Company (19-003062)

The claimant applied to the LAT seeking entitlement to housekeeping and home maintenance expenses, the cost of a chronic pain assessment, and the cost of two OCF-3s. Adjudicator Farlam dismissed the claimant's dispute. The claimant had purchased optional HK expenses in her policy. The insurer paid HK expenses for February 11, 2017 to April 12,...

November 11, 2020

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P.W. v. Aviva Insurance Canada (18-000854)

Both the claimant and the insurer sought reconsideration of the Tribunal's decision which found that the claimant was not entitled to an income replacement benefit but was entitled to an examination expense for an attendant care assessment. Adjudicator Gosio dismissed the claimant's request for reconsideration, but granted the insurer's request for reconsideration by ordering that...

November 10, 2020

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W.A. v. Aviva General Insurance (19-000287)

The claimant sought reconsideration of the Tribunal's decision denying his entitlement to income replacement benefits. Vice Chair Farlam dismissed the claimant's reconsideration request, noting that reconsideration is only warranted in cases where an adjudicator has made a significant legal or evidentiary mistake preventing a just outcome, where false evidence has been admitted, or where genuinely...

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP