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.

May 23, 2024

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Pope v. Pilot Insurance Company (2024 ONSC 2932)

The claimant appealed the Tribunal's decision that her 2002 settlement in relation to a 1995 accident was valid, and that she was not entitled to rescind the settlement. The Settlement Disclosure Notice used in the settlement did not contain some information about the maximum benefits available to her (as required by the SDN at the...

May 22, 2024

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Spencer v. Economical Insurance Company (21-015648)

The applicant was involved in a July 29, 2021 accident and sought $3,000 per month in ACBs from September 9, 2021 onwards. The insurer did not dispute the initial entitlement to the maximum, non-catastrophic quantum of care. The adjudicator awarded her $942.19 per month in ACBs commencing December 9, 2022. She was not entitled to...

May 21, 2024

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Adam v. Aviva General Insurance Company (2024 ONSC 3577)

The claimant appealed the Tribunal's decision that he was not entitled to post-104 week IRBs. The Court rejected the appeal, holding that the Tribunal correctly concluded that the insurer complied with section 37 regarding the denial of IRBs, and the denial did not lack medical reasons or specificity for the denial. The Court also dismissed...

May 6, 2024

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Fagundes v. Intact Insurance (2024 ONSC 2575)

The claimant appealed the Tribunal's decision that she was not entitled to post-104 week IRBs. The Court dismissed the appeal. The Court held that there was considerable evidence on which the Tribunal relied in coming to its conclusion, and the Tribunal was entitled to weigh and prefer the expert evidence of the insurer over the...

May 3, 2024

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Laljee v. Aviva General Insurance Company (2024 ONSC 2577)

The claimant appealed the Tribunal's dismissal of her claim for a catastrophic impairment designation and various treatment plans. The Court dismissed the appeal, finding that there was no merit to the claimant's arguments. The claimant had not been denied procedural fairness, and had been provided with all documentation referred to during the hearing. The Tribunal's...

April 30, 2024

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Nouracham v. Aviva General Insurance Company (2024 ONSC 2415)

The claimant appealed the Tribunal's decision that she was not entitled to IRBs because she was not employed at the time of the accident. The Court dismissed the appeal. The claimant was "on call" with a temp agency, and occasionally worked at a factory for one day or several days at most. She had not...

April 16, 2024

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Shahin v. Intact Insurance Company (2024 ONSC 2059)

The claimant appealed the Tribunal's conclusion that she did not suffer a catastrophic impairment. She argued that she was denied procedural fairness due to: (i) failure by the Tribunal to make the insurer's expert re-attend for cross-examination, (ii) by the Tribunal deciding causation when it was not argued by the parties; and (iii) by the...

April 8, 2024

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Keulen v. Allstate Insurance Co. (2024 ONSC 2033)

The claimant appealed the Tribunal's decision that it did not have jurisdiction to award punitive damages. The Court dismissed the appeal, holding that the Tribunal correctly interpreted its jurisdiction, which was limited to matters provided for in the SABS. The only non-benefit the Tribunal could award was a section 10 award. The Court also rejected...

March 22, 2024

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Travis v. Aviva Insurance Company (2024 ONSC 1683)

The claimant appealed the Tribunal's decision that his injuries were not the result of an accident. The claimant was a firefighter who responded to the 2018 van attacks in Toronto where 10 people were killed. The claimant arrived at the scene after the incident, and was confronted with the bodies of the deceased and injured...

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...

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Contact Us

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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