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 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...

May 3, 2020

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R.M. v. Certas Home and Auto Insurance Company (18-007521)

The claimant sought entitlement to NEBs and medical benefits. The insurer argued that the claims were barred by the limitation period. The claimant argued that her substance abuse issues prevented her from filing an application in a timely manner, and requested an extension of time under section 7 of the LAT Act. Adjudicator Johal concluded...

May 1, 2020

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P.A. v. TD General Insurance Company (19-001349)

The claimant's spouse and children were injured in an accident. He was not involved in the accident, but claimed he suffered from psychological impairments including post-traumatic stress (PTSD), anxiety, depression and insomnia as a result of the accident. He was prescribed medical cannabis to treat the accident related impairments. The insurer paid for the medical...

May 1, 2020

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P.S. v. Aviva General Insurance Company (19-000891)

The claimant sought removal from the MIG and entitlement to various medical benefits, and argued that the insurer failed to comply with section 38. Adjudicator Maleki-Yazdi held that the claimant's injuries fell in the MIG. However, one of the disputed treatment plans was awarded because no denial was ever provided by the insurer. An OCF-23...

April 30, 2020

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Aviva Insurance Company of Canada v. J.A. (2021 ONSC 3185)

The insurer appealed the Tribunal's decision that it was required to pay for the claimant's catastrophic impairment assessments even though the assessments were not requested or completed until after submission of the OCF-19 and the catastrophic impairment IEs. The insurer characterized the requested assessments as rebuttal reports, which were not payable under the current version...

April 30, 2020

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M.A. v. Travelers Insurance Company of Canada (19-008748)

The claimant sought reconsideration of the Case Conference order that an in-person hearing be held rather than a written hearing. Vice Chair Jovanovich dismissed the reconsideration as the order was not a final order disposing of an appeal.

April 29, 2020

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K.W. v. Aviva General Insurance (18-012007)

The claimant sought entitlement to a physiatry assessment and a special award. The assessment had been denied on HCAI, but no denial letter was sent to the claimant until more than two years later. Adjudicator Hines ruled that the insurer was liable to pay for the assessment in accordance with section 38, and granted a...

April 29, 2020

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H.M. v. The Dominion of Canada General Insurance Company (19-001752)

The claimant sought non-earner benefit, medical benefit, a special award and interest. Adjudicator Grant dismissed the claim. Adjudicator Grant held that the claimant did not suffer a complete inability to carry on a normal life as she did not meet the complete inability test based on pre-existing injuries and impairments, post-accident treatment and function of...

April 29, 2020

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C. V. D. W v. Heartland Farm Mutual Inc. (19-001892)

This preliminary issue hearing was brought to determine whether the claimant's application for IRBs and attendant care benefits was statute-barred under s. 55 of the Schedule because it was filed outside of the time limits under s. 32 of the Schedule. Adjudicator Ferguson found that the claimant's application was barred, as she did not submit...

April 28, 2020

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D.G. v. RSA Insurance Company (19-004884)

The claimant sought entitlement to ACBs and HK expenses. The insurer argued that the claimant was barred from contesting the denials as she filed her application over two years after the benefits were denied. Adjudicator Mazerolle ruled that the claimant was allowed to proceed with her claim in accordance with Tomec v. Economical. He noted...

April 28, 2020

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T.S. v Aviva Insurance Canada (18-002858)

The claimant sought entitlement to IRBs which had been terminated, a special award, costs, and interest. The claimant argued that the insurer did not take into account all of his pre-accident employment in calculating his weekly IRB, and that the insurer failed to respond to his IRB application within 10 days and therefore should be...

April 27, 2020

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L.D. v. Gore Mutual Insurance Company (18-011978)

The claimant sought reconsideration of the Tribunal's Case Conference order that a preliminary issue hearing take place to address the IE non-attendance issue, and of the Case Conference adjudicator's refusal to "strike" the issue, arguing that the adjudicator was biased. Vice Chair Jovanovich dismissed the reconsideration request because it was not a final order. Rather,...

April 27, 2020

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J.T. v. Cayuga Mutual Insurance Co.(18-006061)

The claimant sought entitlement to various medical benefits and the cost of an OCF-3. Prior to the hearing, the insurer approved the denied medical benefits, leaving only two issues remaining: a special award, and payment of an OCF-3. The claimant argued that the insurer acted unreasonably by requiring her to attend IEs prior to her...

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Contact Us

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Toronto, Ontario M5H 3S5

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