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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November 5, 2019

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O.I. v. RBC General Insurance Company (18-005774)

The claimant sought entitlement to IRBs for a six months period. Adjudicator Maedel dismissed the claim. He found that the claimant did not suffer job-limiting chronic pain; rather, the claimant suffered some pain in his right shoulder and lower back, but maintained normal range of motion. These impairments did not render him substantially unable to...

November 5, 2019

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C.G. v. Aviva Insurance (18-008957)

The claimant sought removal from the MIG and entitlement to an attendant care assessment and assistive devices. Adjudicator Grant dismissed the claims. He held that the claimant's physical and psychological injuries met the definition of "minor injury". He also rejected the argument that the claimant suffered chronic pain as a result of the accident.

November 1, 2019

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M.R. v. Allstate Insurance Company (17-008969)

The claimant sought reconsideration of the Tribunal's denial of ACBs and order barring the claim for medical benefits based on IE Non-Attendance; the Tribunal had awarded IRBs. Adjudicator Mazerolle held that the Tribunal denials did not meet the criteria in Rule 18 for reconsideration. However, Adjudicator Mazerolle found that the award of IRBs beyond the...

November 1, 2019

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D.M. v. Aviva Insurance Canada (18-008708)

The claimant sought entitlement to a treatment plan for physiotherapy. Adjudicator Grant held that the treatment plan was not reasonable and necessary. The claimant's evidence did not show that physiotherapy was anticipated to provide any benefit. Further, the claimant stated to IE assessors that physiotherapy was not providing long-term benefit.

October 31, 2019

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S.K. v. Aviva Insurance Company (18-007679)

The claimant sought entitlement to NEBs. Adjudicator Grieves dismissed the claim. She held that the claimant failed to provide evidence regarding the change in his pre-accident versus post-accident daily activities. The claimant remained independent with personal care, continued to drive, prepare meals, and completed most household chores.

October 30, 2019

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S.A. v. Aviva Insurance Company (18-006278)

The claimant sought reconsideration of the Tribunal's denial of part of a chronic pain program, a bone growth stimulator, and an MRI. Adjudicator Lake dismissed the reconsideration. She held that the claimant failed to prove that the Tribunal made an error of law or fact. In essence, the claimant was seeking a re-weighing of the...

October 30, 2019

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H.S.H. v. Aviva Insurance Company (18-002204)

The claimant sought entitlement to two medical benefits, and a series of catastrophic impairment assessments. Adjudicator Reilly rejected all of the claims. She held that the proposed benefits were not reasonable and necessary. The medical records from the family physician shows no ongoing accident-related impairments.

October 30, 2019

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Allstate Insurance Company v. Billard (2019 ONSC 6256)

The insurer sought judicial review of the Tribunal's decision that the limitation period should be extended based on section 7 of the LAT Act. The Divisional Court dismissed the review on the basis that the LAT proceeding needed to first be completed in its entirety before seeking judicial review.

October 29, 2019

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P.M. v. Aviva Insurance Canada (17-005419)

The claimant sought entitlement to IRBs and medical benefits. She also sought entitlement to an accounting report. Adjudicator Watt denied the claim for IRBs, as the claimant had been paid IRBs up to the date she returned to work on a modified basis. He found the treatment plans not reasonable and necessary. Finally, he held...

October 29, 2019

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M.D. v. The Co-operators General Insurance Company (18-009426)

The claimant sought removal from the MIG and entitlement to three medical benefits for physical therapy. Adjudicator Victor held that the claimant's injuries were predominantly minor. She preferred the opinions of the IE assessors. She also noted that the claimant had returned to work a few days after the accident.

October 28, 2019

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J.G. v. The Co-operators General Insurance Company (18-012430)

The claimant sought reconsideration of the Tribunal's decision that the claim for NEBs was barred by the limitation period. The claimant also sought further benefits, which were not addressed in the preliminary hearing. Associate Chair Batty dismissed the reconsideration request because it was not a final order disposing of the entire dispute.

October 28, 2019

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M.H. v. Western Assurance Company (18-009498)

The claimant sought reconsideration of the Tribunal's decision that the claim for IRBs was barred by the limitation period. The claimant also sought further benefits, which were not addressed in the preliminary hearing. Associate Chair Batty dismissed the reconsideration request because it was not a final order disposing of the entire dispute.

October 28, 2019

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P.M. v. Aviva Insurance Company (19-002717)

The claimant sought reconsideration of the Tribunal's motion order that permitted the insurer to cross-examine the claimant on her affidavit. Associate Chair Batty dismissed the reconsideration request because it was not a final order disposing of the dispute.

October 28, 2019

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J.B.W. v. Aviva General Insurance (18-008128)

The claimant sought removal from the MIG and entitlement to a treatment plan for chiropractic therapy. The insurer had requested the claimant's attendance at an IE to address the MIG and the medical benefits. The claimant failed to attend, and the insurer argued that claim was barred by section 55. Adjudicator Goela held that the...

October 28, 2019

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Fordjour v. Royal and Sun Alliance Insurance Company of Canada (2019 ONSC 6268)

The claimant judicial review of the dismissal of her claim on two grounds: that she her family physician should be entitled to give opinion evidence, and that the adjudicator did not properly address causation. The Divisional Court agreed with the claimant and remitted the matter for a new hearing. It held that the Tribunal erred...

October 24, 2019

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A.M.F. v. The Dominion of Canada General Insurance Company (17-006710)

The insurer sought reconsideration of the Tribunal's decision that the claimant suffered a catastrophic impairment and that she was entitled to two medical benefits for physical therapy. Adjudicator Parish rejected the reconsideration. She found that all of the insurer's arguments essentially amounted to re-argument of the case. The Tribunal was not required to make note...

October 24, 2019

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Z.L. v. Certas Direct Insurance Company (18-004297)

The claimant sought removal from the MIG and entitlement to three medical benefits. Adjudicator Boyce dismissed the claim and held that the claimant had abandoned the application due to his failure to submit and written submissions or participate in any of the preliminary stages of the LAT dispute.

October 23, 2019

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P.G. v. Intact Insurance Company (18-005386)

The claimant sought entitlement to ongoing IRBs and over $20,000 in assessments related to the IRB claim. Adjudicator Parish held that the claimant was entitled to IRBs up to the 104-week mark, but that the claimant's functionality did not meet the "complete inability" test. She also awarded the cost of an occupational therapy situational assessment,...

October 22, 2019

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M.P. v. Aviva General Insurance Canada (18-006624)

The claimant initially sought entitlement to various medical benefits and IRBs. The insurer approved the benefits before the hearing. The claimant still sought a special award. Adjudicator Fricot held that a special award of $1,500 was payable. She reasoned that once an IE confirming that the claimant's injuries fell outside the MIG had been received,...

October 22, 2019

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P.W. v. Economical Insurance (18-008457)

The claimant sought entitlement to IRBs. Adjudicator Boyce held that the claimant failed to prove his claim because he had not made any written submissions or evidence regarding the claim. Adjudicator Boyce also noted that the claimant was not employed at the time of the accident, had not worked for 26 of the previous 52...

October 22, 2019

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M.C. v. Wawanesa Mutual Insurance Company (18-002854)

The insurer sought reconsideration of the Tribunal's decision to award IRBs. Adjudicators Parish and Maleki-Yazdi rejected the reconsideration. They held that the award of IRBs "to date and ongoing" was not outside of the jurisdiction of the LAT, and that the claimant was entitled to IRBs as long as she met the appropriate disability test....

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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