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 21, 2020

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Unica Insurance Inc. v. K.B. (19-006165)

The claimant had been paid ACBs by the insurer based on the alleged economic loss sustained by his mother, who was seeking employment at the time of the accident. In an earlier decision by the Tribunal, it was held that the mother did not suffer an economic loss. The insurer then sought repayment of $19,170.90...

May 21, 2020

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A.A. v. Unifund Assurance Company (18-008999)

The claimant had previously been deemed catastrophically impaired. She applied to the LAT seeking entitlement to ACBs, medical benefits that had been denied prior to her being deemed catastrophically impaired, and medical benefits that had been denied after she was declared catastrophically impaired. Adjudicator Punyarthi found that the claimant was entitled to ACBs, but based...

May 20, 2020

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K.R. v. Certas Direct Insurance Company (19-003237)

The claimant sought payment of $11,865 for hockey training. The claimant had been actively engage in competitive hockey, and sought to regain physical strength and skill to return to pursue her goal of playing NCAA hockey. Adjudicator Parish dismissed the claim. She held that the claimant failed to comply with section 38(2) by incurring the...

May 20, 2020

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W.R. v. Aviva Insurance Company (19-000791)

The insured died while in his vehicle due to a suicide, in which he poured gasoline in his vehicle and set it on fire using the car's cigarette lighter and a doused dishtowel. The claimant (the insured's wife) sought death benefits and funeral benefits. Adjudicator Farlam held that the death was not a result of...

May 19, 2020

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L.M. v Portage La Prairie Mutual Insurance Company (19-004596)

The claimant disputed her entitlement to attendant care benefits and various medical benefits. Adjudicator Boyce determined that the claimant was not entitled to ACBs for the period in dispute, as they are not reasonable and necessary and the claimant did not provide evidence that the services were incurred. The claimant offered no evidence or substantive...

May 19, 2020

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L.R. v Economical Mutual Insurance Company (19-005496)

The claimant sought entitlement to a special award, taking the position that the insurer unreasonably delayed the payment of a treatment plan for physiotherapy services because the insurer approved the treatment plan after submission of the LAT Application. The claimant did not make any submissions or provide any evidence in support for an award, as...

May 19, 2020

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M.I. v. Coseco Insurance Company (18-000742)

The insurer suspended the claimant's entitlement to IRBs. The claimant applied to the LAT. Before the Case Conference, the insurer reinstated the IRBs. The insurer argued that the LAT did not have jurisdiction to consider the claim for IRBs. Adjudicator Kepman concluded that the Tribunal did not have jurisdiction under the Insurance Act to consider...

May 19, 2020

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A.T. v. TD Insurance Meloche Monnex (19-003627)

The claimant sought lost educational expenses following an accident. At the time of the accident, he was enrolled in a post-secondary computer programming program. He alleged that he was unable to continue in the program and did not qualify for a refund of tuition. Adjudicator Norris dismissed the claim, holding that the claimant failed to...

May 15, 2020

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Z.X.C. v Belair Insurance Company (19-000314)

The claimant disputed her MIG determination, as well as entitlement to various medical benefits and IRBs. Adjudicator Shapiro concluded that based on the medical evidence, the claimant suffered predominantly minor physical injuries - strains and sprains - as a result of the accident, and her injuries thus fell within the MIG. Adjudicator Shapiro also determined...

May 14, 2020

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T.H. v Allstate Insurance Company of Canada (19-004567)

The claimant disputed her entitlement to two denied treatment plans, one for optometric services and one for occupational therapy services. The insurer took the position that the claimant's impairments for which she sought treatment were not sustained as a result of the accident. Adjudicator Paluch disagreed, finding that but for the accident, the claimant would...

May 14, 2020

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Applicant v. TD Insurance Meloche Monnex (19-006032)

The claimant sought non-earner benefits, a special award and interest. The insurer raised a preliminary issue to determine whether the claimant was precluded from proceeding with her application as she failed to attend a s.44 IE. The insurer also sought costs of the failed IE attendance. The claimant argued that the insurer did not provide...

May 13, 2020

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Yang v. TD General Insurance Company (19-005396)

This is a preliminary issue decision addressing whether the claimant was barred from proceeding with the claim for failing to commence the LAT application within two years after the insurer's refusal to pay the amount claimed. Adjudicator Parish decided not to exercise her discretion to extend the limitation period under s. 7 of the LAT...

May 11, 2020

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R.E. v Aviva Insurance Company (19-000303)

The claimant disputed his MIG determination, as well as entitlement to various medical benefits and IRBs. Adjudicator Boyce concluded that the claimant sustained predominantly minor injuries as defined by the SABS that were properly treated within the MIG, noting that the medical evidence relied upon was "incredibly underwhelming". Adjudicator Boyce further concluded that the claimant...

May 11, 2020

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J.B. v Motor Vehicle Accident Fund (19-003638)

The claimant disputed her entitlement to attendant care benefits and various medical benefits. Adjudicator Paluch found that the claimant was not entitlement to attendant care for the period in dispute because she did not submit a Form 1 in accordance with the SABS nor did she demonstrate that her expenses were incurred. However, Adjudicator Paluch...

May 8, 2020

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S.P. v Aviva General Insurance Company (18-008876)

The claimant disputed her MIG determination, as well as entitlement to various medical benefits and IRBs. Adjudicator Helt found that the clamant did not suffer from chronic pain so as to remove her from the MIG, noting that the medical records failed to establish that she claimant complained of persistent chronic pain issues causing functional...

May 8, 2020

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D.K. v Aviva Insurance Company (18-008371)

The claimant disputed her entitlement to IRBs. The parties agreed that the claimant was unable to work and was entitled to an IRB, but disagreed as to the quantum the claimant was entitled to. The claimant did not provide any written submissions for the hearing other than an email to the Tribunal with the accountant's...

May 8, 2020

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R.S. v Pafco Insurance Company (19-006331)

The claimant sought catastrophic determination as a result of his accident-related injuries, and underwent assessments in preparing his OCF-19. After receiving the claimant's CAT Application, the insurer requested that the claimant attend various IEs in order to assess him for CAT. The claimant refused to attend the neuropsychological IE, arguing that it was not reasonably...

May 7, 2020

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Bouianov v. Travelers Insurance (19-005097)

The claimant sought entitlement to treatment outside of the MIG and benefits proposed in two treatment plans. The insurer raised the preliminary issue of whether the claimant was barred from proceeding with the claim as he failed to commence his application within two years after the insurer's refusal to pay the amount claimed. The LAT...

May 6, 2020

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Applicant v. Aviva General Insurance (19-007805)

The claimant sought payment of medical benefits and the cost of an assessment, which the insurer agreed to pay by the time of the hearing. The claimant then sought interest on the cost of the assessment. The claimant argued that an OCF-18 for an assessment and invoices were submitted to the insurer on March 28,...

May 5, 2020

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M.M. v Aviva General Insurance Company (18-007868)

The claimant disputed her entitlement to NEBs and medical benefits, including chiropractic services and a chronic pain assessment. The respondent challenged the claimant's credibility through the use of surveillance video that seemingly contradicted her self-reported, accident-related limitations. The claimant was observed driving, shopping at a busy mall, interacting with store clerks, and jaywalking, all with...

May 5, 2020

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J.P. v. Aviva General Insurance (19-004854)

The claimant sought attendant care benefits for two separate periods post-accident, a special award and interest on overdue payments. The insurer argued that the claimant failed to provide proof of expenses incurred for the periods claimed and his wife, who was a retired nurse at the time that she provided care to the claimant, failed...

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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