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.

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....

October 21, 2019

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R.K. v. Aviva General Insurance Company (18-007866)

The claimant sought removal from the MIG and entitlement to four medical benefits. Adjudicator Norris held that the claimant's injuries fell within the MIG. He rejected the arguments that the claimant suffered from pre-existing injuries, psychological injuries, or chronic pain.

October 21, 2019

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R.F. v. Unifund Assurance Company (18-007571)

The claimant sought removal from the MIG and entitlement to two medical benefits for further physiotherapy. Adjudicator Mazerolle concluded that the claimant suffered a psychological impairment as a result of the accident, and was not restricted by the MIG limits. He awarded the two claimed medical benefits, writing that such treatment was promoting the claimant's...

October 21, 2019

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I.G. v. Security National Insurance Company (19-000292)

The claimant sought entitlement to NEBs, ACBs, and various medical benefits. The insurer argued that the claimant failed to notify it of the circumstances giving rise to the claims, and failed to submit an application in the time prescribed. Adjudicator Boyce permitted the claim to proceed despite the late application. He accepted that the claimant...

October 18, 2019

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D.K. v. Aviva General Insurance (18-007372)

The claimant sought entitlement to two medical benefits for further chiropractic treatment. Adjudicator Norris awarded the first treatment plan, holding that the treatment was providing the claimant with functional improvement at that time. The second treatment plan was denied. By that time, the claimant had returned to work on a full time basis and there...

October 18, 2019

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E.C. v. Aviva Insurance Company (18-003072)

The insurer argued that the claimant was not involved in an accident. The claimant had driven to work and was removing items from the trunk of the vehicle. At some point either during the closing of the trunk or shortly thereafter, the claimant slipped and fell, and injured himself. Adjudicator Norris concluded that the claimant...

October 16, 2019

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B.D.W. v. Aviva General Insurance Company (18-006313)

The insurer sought reconsideration of the Tribunal's award of one medical benefit. Adjudicator Parish rejected the reconsideration, writing that the Tribunal's decision was based on a weighing of the evidence and the varying opinions of the experts. There was nothing in the decision suggesting that the Tribunal acted outside its jurisdiction or violated the rules...

October 16, 2019

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N.D. v. Unifund Assurance Company (17-008580)

The claimant sought reconsideration of the Tribunal's denial of a chiropractic treatment plan and a psychiatric assessment, arguing that the Tribunal made an error of fact and law. Adjudicator Hans denied the reconsideration request. Regarding the chiropractic treatment plan, the Tribunal had ample evidence to come to the conclusion that it was not reasonable and...

October 15, 2019

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L.V.K. v. TD General Insurance Company (18-008640)

The claimant sought removal from the MIG and entitlement to four medical benefits for physical therapy and medical cannabis. Adjudicator Kershaw rejected the claimant's argument that he suffered from a concussion, chronic pain, or a psychological impairment. She also rejected that his pre-existing injuries may have prevented maximal recovery under the MIG.

October 15, 2019

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D.K.M. v. Aviva General Insurance Company (18-010072)

The claimant sought removal from the MIG and entitlement to physiotherapy. Adjudicator Maleki-Yazdi concluded that the claimant suffered chronic pain syndrome, which entitled him to non-MIG benefits. The proposed physiotherapy was reasonable and necessary for improving the claimant's pain level, functionality, and strength.

October 15, 2019

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Applicant v. Unica Insurance Company (17-007052)

The claimant sought reconsideration of the Tribunal's order that she did not suffer a catastrophic impairment and that she was not entitled to a chronic pain assessment. Vice Chair Lester rejected the reconsideration, holding that the Tribunal had weighed the evidence before it and had good reason to give more weight to the insurer's assessors....

October 11, 2019

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G.R. v. Travelers Canada (18-007870)

The claimant sought entitlement to attendant care benefits. Adjudicator Watt dismissed the claim. He held that the claimant had failed to submit a Form 1, that she had not incurred and attendant care expenses, and that she did not require attendant care services from a medical perspective.

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP