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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October 26, 2017

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Applicant v. Aviva Insurance (17-000760)

The non-MIG claimant sought entitlement to various medical benefits and examinations. Adjudicator Maedel rejected all of the claims. He accepted the opinions of the insurer's assessors over the claimant's assessors due to the specificity of testing and multiple examinations of the claimant. He also wrote that the claimant's submissions often lacked specific evidence in support...

October 25, 2017

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D.N. v. Aviva Insurance (17-004104)

The claimant failed to provide records as ordered by the Case Conference adjudicator, and submitted his written materials 15 days late. The insurer sought to have the claim dismissed and requested costs. Adjudicator Paluch held that the dismissal of a claim should only occur with utmost caution in unusual circumstances. However, he was prepared to...

October 24, 2017

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Applicant v. Aviva Insurance (17-001023)

The claimant sought entitlement to IRBs and various medical benefits. Adjudicator Sewrattan held that the claimant did not suffer a substantial inability to engage in his pre-accident work (he admitted to being able to drive, which was a major component of his job). He also held that the claimant was not entitled to proposed assessment...

October 24, 2017

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Applicant v. Allstate Insurance Company of Canada (17-003121)

The claimant sought an summons for the claims adjustor and the manager of the claims adjustor to attend a hearing. The claims adjustor was listed on the Case Conference Order as a witness; the manager was not. Adjudicator Paluch held that the claimant had not complied with Rule 8.2 regarding the request for a summons...

October 20, 2017

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H.A.-R. v. Aviva Insurance (16-003039)

The claimant brought an application before the LAT. One year following the case conference, the claimant withdrew the claim. The insurer sought its costs. Adjudicator Robert Watt reviewed Rule 19.1 and determined that withdrawing an application on the eve of a hearing did not constitute unreasonable, frivolous, vexations, or bad faith behaviour to warrant an...

October 19, 2017

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S.V. v. Aviva Insurance Company (17-002973)

The claimant sought an adjournment after two case conferences. The insurer requested a dismissal. Adjudicator Cezary Paluch noted that the claimant was effectively seeking an extension in timelines for submissions and should have properly brought documentation under Rule 15, than seeking an adjournment. Moreover, although the submissions of the claimant were late, Adjudicator Paluch ruled...

October 19, 2017

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I.C. v. Intact Insurance Company (16-003163)

The claimant sought entitlement to medical benefits. The insurer asserted an accident had not occurred under the definition in the SABS. The incident giving rise to the application involved the claimant car surfing on the rear of a motor vehicle. When the vehicle took a sharp turn, the claimant fell and suffered a severe head...

October 19, 2017

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G.R. v. Aviva Insurance Canada (17-001146)

The claimant sought entitlement to a number of medical treatment plans. On review of the medical evidence, Adjudicator Chris Sewrattan determined that the claimant suffered from both physical and psychological impairments, and that a choice was available with respect to the modality of treatment to reduce pain. Pain relief and increasing strength were considered reasonable...

October 19, 2017

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Applicant v. Aviva Insurance Canada (17-001088)

The claimant sought entitlement to two treatment plans. The insurer arranged two IEs, but the claimant did not attend. The insurer raised a preliminary issue, asserting the claimant was not compliant with an IE and therefore barred from bringing a claim before the LAT. Adjudicator Avvy Go reviewed the notice sent to the claimant and...

October 18, 2017

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D.A. v. The Personal Insurance Company (17-001941)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to various medical benefits and costs of examinations. As a preliminary issue, the claimant requested to know the number of reports that each of the IE assessors had provided to the respondent for the last three years and the cost...

October 18, 2017

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T.F. v. Peel Mutual Insurance Company (16-003316)

The claimant sought entitlement to medical benefits. The insurer arranged IE assessments for which the claimant did not attend, and therefore sought to preclude the application for arbitration based on section 55. The claimant asserted the insurer's notice letters were non-complaint; however, Adjudicator Nicole Treksler determined the notice correspondence of the insurer included sufficient medical...

October 18, 2017

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S.C. v. Aviva Canada Inc. (17-001537)

The claimant sought entitlement to a number of medical treatment plans. The insurer denied the plans based on a MIG designation and scheduled IEs. The claimant failed to attend and instead brought an application for arbitration. The insurer brought a motion to preclude the claims given the claimant's non-attendance at IEs pursuant to section 55....

October 18, 2017

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Applicant v. State Farm Insurance Company (16-003195)

The claimant sought entitlement to non-earner benefits. The insurer asserted the claimant did not suffer a complete inability to carry on a normal life. Adjudicator Cezary Paluch, on review of the medical evidence, as well as testimony from the claimant, determined that the claimant met the disability test for non-earner benefits. In doing so, the...

October 18, 2017

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Applicant v. Pafco Insurance (16-003683)

The claimant sought entitlement to income replacement benefits. The insurer denied the benefit based on a number of IE reports. It was noted that the insurer continued to pay IRBs beyond the denial letter. The insurer admitted the payments were due to inadvertence and sought repayment. Adjudicator Robert Watt reviewed the medical evidence and concluded...

October 18, 2017

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Applicant v. Motor Vehicle Accident Claims Fund (17-000665)

The claimant sought removal from the MIG and entitlement to various medical benefits for physical therapy and psychological therapy. Adjudicator Markovits held that the claimant was suffering from an adjustment disorder with mixed anxiety and depressed mood, and that his injuries were therefore non-minor. In terms of the medical benefits sought, Adjudicator Markovits awarded all...

October 18, 2017

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Applicant v. Aviva Insurance (17-002240)

The claimant sought entitlement to non-earner and medical benefits. The insurer denied the benefits and asserted a MIG position. On review of the medical evidence, Adjudicator Avvy Go held the claimant suffered a minor injury with no pre-existing injury and was therefore governed by the MIG. Moreover, the medical evidence did not support the claimant...

October 16, 2017

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C.N. v. Aviva Canada Insurance (16-002658)

The claimant failed to attend two case conferences. Accordingly, the insurer sought to have the matter dismissed. The claimant argued that the matter was merely withdrawn and therefore it was available to return to the LAT to raise the same issues. The case conference adjudicator agreed with the claimant and found the issues withdrawn. The...

October 13, 2017

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B.M. v. Aviva Insurance Canada (17-000907)

The claimant was riding on a motorcycle at a privately owned and operated, training and racing facility. The motorcycle owner's manual indicated that the vehicle was designed for closed course competitions only. The motorcycle was not registered with an insurance policy nor was it plated with the Ministry of Ontario. On the day of the...

October 13, 2017

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Applicant v. Certas Direct Insurance (16-004092)

The insurer argued that the claimant had failed to attend a requested IE, and therefore could not pursue his claim for two medical benefits. Adjudicator Go held that the insurer's IE request letter did not satisfy the requirements of section 44 in failing to provide medical reasons for the examination. The claimant was therefore permitted...

October 13, 2017

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Applicant v. Aviva Insurance Company of Canada (16-001934)

The claimant sought entitlement to a chronic pain assessment. The insurer denied the assessment. Adjudicator Chris Sewrattan referenced a previous decision in the same matter where it was held that it was reasonably possible the claimant suffered from chronic pain syndrome. Based on the medical evidence, Adjudicator Sewrattan reasoned that a chronic pain assessment was...

October 12, 2017

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The Applicant v. Aviva General Insurance (17-004239)

The claimant sought entitlement to one treatment plan for chiropractic treatment. Adjudicator Treksler concluded that although the claimant had been diagnosed with whiplash as a direct result of the accident, she had not provided any objective medical opinion to support that the chiropractic treatment would improve or resolve her injuries. The claimant was not entitled...

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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