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.

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July 16, 2018

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Applicant v. Desjardins General Insurance Group (17-005974)

The claimant sought entitlement to seven treatment plans and a special award. Adjudicator Purdy granted all the claims. She concluded that the medical evidence showed a compression fracture was directly caused by the accident, and that the proposed treatment was appropriate for addressing the injury. She was critical of the IE assessor focusing on standard...

July 16, 2018

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Applicant v. Royal Sun Alliance (RSA) (17-006236)

The claimant sought entitlement to two years of IRBs, removal from the MIG, and six treatment plans. Adjudicator Punyarthi concluded that the claimant sustained a concussion and that his injuries were therefore not minor. All of the disputed treatment plans were awarded because they directly addressed the impairments the claimant was suffering. Finally, Adjudicator Punyarthi...

July 16, 2018

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Applicant v Aviva Insurance Canada (17-006470)

The applicant sought medical benefits for a massage therapy chair and extended warranty. Adjudicator Ferguson held that the applicant was entitled to the benefit claimed as it was reasonable and necessary. The applicant was also entitled to interest on overdue payment of benefits due. The adjudicator preferred the applicant's treatment plan from an occupational therapist...

July 13, 2018

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Applicant v. The Guarantee Company of North America (17-004431)

The claimant sought entitlement to treatment outside of the MIG, and NEBs. Adjudicator Gosio held that the claimant's injuries fell within the MIG. Adjudicator Gosio held that while the claimant had pre-existing back pain, she failed to submit compelling evidence that her pre-existing back pain prevented her from achieving maximal medical recovery within the MIG....

July 12, 2018

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S.K. v. TTC Insurance (17-002561)

The Tribunal found that the claimant sustained a catastrophic impairment due to two marked impairments. The insurer sought reconsideration based on a number of arguments. Vice Chair Trojek rejected the reconsideration. She held that there was no requirements that the adjudicator convert the marked impairment into a WPI. She also wrote that the adjudicator considered...

July 10, 2018

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S.B. v. Wawanesa Mutual Insurance Company (17-004020)

The claimant sought entitlement to the cost of an in-home assessment and chiropractic treatment proposed in one treatment plan. Adjudicator Daoud found that the claimant was not entitled to the benefits in dispute. Adjudicator Daoud held that experiencing some difficulty with housekeeping and home maintenance tasks does not warrant the need for an in-home assessment.

July 6, 2018

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Applicant v. Unifund Assurance Company (17-008769)

The claimant sought disclosure of any surveillance in the insurer's possession, whether it intended on relying upon it or not. Adjudicator Grieves held that while any surveillance in the insurer's possession was relevant, it was not producible if litigation privilege would apply to it (i.e. if it was obtained after the LAT dispute was commenced...

July 3, 2018

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Applicant v. Certas Home and Auto Insurance Company (17-006967)

The claimant sought a determination that her impairments were outside of the MIG as well as entitlement to medical benefits proposed in two treatment plans. Adjudicator Parish found that the claimant was removed from the MIG as a result of the insurer's failure to comply with the "medical and all other reasons" requirement in s....

June 29, 2018

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Applicant v Aviva Insurance Canada (16-003638)

The claimant sought removal from the MIG, entitlement to NEBs, nine disputed treatment plans, interest, costs, and a special award. Adjudicator Gosio concluded that the claimant's psychological injuries warranted treatment outside of the MIG, and approved one of the treatment plans sought. However, Adjudicator Gosio held that the claimant was not entitled to NEBs, payment...

June 29, 2018

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Applicant v Wawanesa (17-004541)

The claimant sought removal from the MIG, entitlement to medical benefits, and interest. The claimant argued that pre-existing back degenerative changes, in conjunction with his alleged chronic pain, warranted treatment outside of the MIG. The claimant further claimed that he had incurred significant treatment expenses to enable him to return to employment, and relied on...

June 29, 2018

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Z.V. v Aviva Insurance Canada (17-006874)

The claimant sought treatment outside of the MIG, entitlement to a disputed chiropractic treatment plan, a special award, and interest. The claimant argued that she had been removed from the MIG as the insurer had approved previous treatment plans above the MIG limits. The insurer, however, claimed that these approvals were an administrative error, and...

June 29, 2018

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R.K. v. Aviva Insurance Company (17-006651)

The claimant sought payment of attendant care benefits. The insurer did not dispute that services were reasonable and necessary, but argued that the claimant had not incurred such expenses. The claimant refused to provide answers to questions regarding the services during an examination under oath, and the invoices proving receipt of the services was vague...

June 29, 2018

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S.K. v. Aviva Insurance Company (17-006866)

The claimant sought payment of attendant care benefits. The insurer did not dispute that services were reasonable and necessary, but argued that the claimant had not incurred such expenses. The claimant refused to provide answers to questions regarding the services during an examination under oath, and the invoices proving receipt of the services was vague...

June 28, 2018

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S.H. v Certas Home and Auto Insurance Company (17-006504)

The claimant sought entitlement to IRBs and interest. The insurer raised a third issue at the hearing, as to whether the claimant had complied with a production order. The claimant argued that she was entitled to IRBs, as she continued to receive treatment for her accident-related injuries. Adjudicator Boyce disagreed, noting that the test for...

June 28, 2018

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Applicant v. Aviva Insurance Canada (17-005950)

The claimant sought entitlement to IRBs and three medical benefits. Adjudicator Go dismissed all of the claims other than the claimed psychological assessment. She held that there was insufficient information to support objective limitations or restrictions to support the IRB claim, and the claimant had not provided sufficient information to quantify the IRB even if...

June 27, 2018

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Applicant v The Guarantee Company of North America (17-006422)

The claimant sought entitlement to a treatment plan for physiotherapy services, and interest. Vice-Chair Flude preferred the evidence of the claimant's physiotherapist to that of the respondent's neurologist, and awarded the disputed treatment plan and interest.

June 27, 2018

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Applicant v Aviva Insurance Canada (16-005271)

The Tribunal was asked to determine whether, after the claimant withdrew an application prior to a hearing, the respondent was entitled to costs, and whether the Tribunal had the jurisdiction to hear a motion for costs. Adjudicator Norris determined that the Tribunal did have the jurisdiction to hear the respondent's request for costs, as the...

June 27, 2018

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B.H. v. Certas Home and Auto Insurance Company (17-006692)

The claimant sought entitlement to the cost of an accounting report and interest on IRBs. The insurer had paid IRBs at a lower rate and then increased the weekly IRB payment upon receipt of further information. Adjudicator Ferguson held that the insurer was not required to pay for the accounting report because the claimant was...

June 25, 2018

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U.S. v. Certas Home and Auto Insurance Company (17-007003)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to benefits proposed in five treatment plans. Adjudicator Lake found that the claimant's injuries fell within the MIG and that the treatment plans in dispute were not payable as the MIG limits had been exhausted.

June 25, 2018

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Applicant v. TTC Insurance Company Limited (17-004391)

The claimant sought entitlement to various medical benefits for physical therapy, a psychological assessment, and psychological therapy. Adjudicator Ferguson denied the claims for physical therapy because the claimant had not demonstrated that her pain complaints were related to the accident. He awarded the $200 form fee related to the psychological assessment, and awarded the remainder...

June 21, 2018

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F.A. v. Aviva Insurance Canada (17-005508)

The claimant sought a determination that his impairments were outside of the MIG as well as entitlement to medical benefits proposed in three treatment plans. The claimant argued that he should be removed from the MIG due to chronic pain and pre-existing injuries from a previous motor vehicle accident. Adjudicator Maleki-Yazdi held that for chronic...

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Contact Us

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

416.507.1850

smilne@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP