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 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...

November 10, 2020

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B.D. v Aviva General Insurance (18-010618)

The claimant asked for a reconsideration of part of the Tribunal's decision regarding the denial of an orthopaedic assessment. Vice Chair Farlam was satisfied that the decision did not contain any errors of law or fact. Having accepted some of the evidence in the orthopaedic assessment did not obligate the adjudicator to find that the...

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...

November 9, 2020

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L.D. v. Gore Mutual Insurance Company (17-002762)

The claimant brought two motions: (1) that Vice-Chair Flude recuse himself from making a decision that he already made on May 27, 2020; and (2) that he then reconsider the same decision. Claimant's counsel had previous requested that Vice-Chair Flude recuse himself, alleging bias stemming from a comment that was interpreted to be insensitive, for...

November 9, 2020

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L.D. v. Gore Mutual Insurance Company (17-002762)

The claimant brought two motions: (1) that Vice-Chair Flude recuse himself from making a decision that he already made on May 27, 2020; and (2) that he then reconsider the same decision. Claimant's counsel had previous requested that Vice-Chair Flude recuse himself, alleging bias stemming from a comment that was interpreted to be insensitive, for...

November 5, 2020

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P.K. v. Coseco Insurance Company (19-004126)

The claimant sought entitlement to various medical benefits for physiotherapy services, representing the balances owing on several treatment plans approved by the insurer and invoiced some months after the services were incurred by the claimant. The insurer did not dispute the reasonableness and necessity of the disputed benefits, but rather that payment of the benefits...

November 5, 2020

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Gareau v. Economical Mutual Insurance Company (19-011520)

This is a preliminary decision over whether a claimant could apply to the Tribunal and dispute his claim for a housekeeping and home maintenance expenses denied by the insurer prior to receiving a catastrophic impairment designation, despite the claimant not yet being found to suffer a catastrophic impairment. Adjudicator Johal held that based on the...

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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