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.

March 21, 2024

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Ravilotchanan v. Allstate Insurance Company of Canada (2024 ONSC 1629)

The claimant appealed the Tribunal's decision that she was responsible for repayment of $23,600 in IRBs and $5,970.92 in ACBs. The Tribunal ordered the repayment based on the claimant working as a PSW at the same time she was receiving benefits. The disclosure of the information was made after the claimant had received a substantial...

March 15, 2024

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Yatar v. TD Insurance Meloche Monnex (2024 SCC 8)

The claimant appealed the Tribunal's decision that her claim for IRBs was barred by the limitation period. One of the main issues was whether the claimant was entitled to pursue judicial review of the Tribunal's decision, in addition to the statutory right of appeal. The Tribunal's decision was upheld by the lower appellate courts, and...

March 1, 2024

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Jiang v. The Co-operators General Insurance Company (2024 ONSC 1225)

The claimant appealed the Tribunal's decision that she was not involved in an accident. The claimant sustained injuries when she was driving and her husband physically assaulted her. She subsequently lost control of her vehicle and hit the curb. The Tribunal held that the assault was an intervening event that broke the chain of events,...

February 12, 2024

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Petiquan v. Economical Insurance Company (22-001808)

The claimant sought entitlement to attendant care benefits in the amount of $6,000 per month from the date of loss to the date of the subject hearing. The claimant was involved in a single vehicle accident on July 8, 2021, in which he sustained a left subdural hemorrhage and various fractures. At the time of...

February 7, 2024

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Co-operators Insurance Company v. Bennett (2024 ONSC 467)

The insurer appealed the Tribunal's decision that the claimant was entitled to an attendant care assessment due to having pre-existing conditions, despite suffering only minor injuries. The insurer argued that the minor injury bar still applied to attendant care benefits and assessments for persons with pre-existing conditions who were not subject to the $3,500 MIG...

February 7, 2024

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Adams v. Aviva Insurance Company (2024 ONSC 715)

The claimant appealed the Tribunal's decision that her late application barred her claim for accident benefits. The accident was on August 28, 2018. The claimant notified the insurer of the accident on June 13, 2019. The Tribunal held that the claimant did not have a reasonable excuse for the delay, and dismissed the application. The...

January 4, 2024

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Rao v. Wawanesa Mutual Insurance Company (2024 ONSC 39)

The claimant appealed the Tribunal's decision that she did not suffer a catastrophic impairment. The claimant had sought an extension of time for reconsideration, which was denied by the Tribunal. The denial of the reconsideration extension lead to the claimant appealing to the Divisional Court more than four months after the original decision of the...

December 6, 2023

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Gayle v. TD General Insurance Company (22-0050088)

The claimant’s husband was allegedly struck by a vehicle insured by the insurer on December 8, 2020. The claimant and her husband were not insured. The claimant sought accident benefits for psychological injuries resulting from the incident. The insurer denied her claim, stating she is not an "insured person" under section 3(1) of the SABS...

November 1, 2023

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El-Dayeh v. Aviva General Insurance (19-006713)

This reconsideration decision stems from the Applicant requesting reconsideration of the Tribunal’s April 26, 2023 decision. Among other things, the Applicant alleged that the Tribunal erred in law by interpreting s. 42 of the SABS as preventing the submission of a new Form 1 for attendant care because less than 52 weeks had passed since...

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...

October 3, 2023

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Atkinson v. Economical Mutual Insurance Company (22-002008)

The claimant sustained a non-catastrophic impairment and applied to the Licence Appeal Tribunal (“LAT”) to dispute entitlement to attendant care benefits (“ACB”), medical benefits, housekeeping expenses, and occupational therapy services. Regarding the ACB claim, Adjudicator Forbes found that the claimant was not entitled to the claimed amount of $10,228.37 per month. Instead, Adjudicator Forbes accepted...

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...

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com