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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May 14, 2019

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M.K. v. Aviva Insurance Canada (18-001128)

The claimant sought entitlement to the balance of a partially approved psychological assessment. Adjudicator Punyarthi held that the claimant was not entitled to the remaining balance as there was no evidence substantiating the claimant's entitlement. The adjudicator specifically noted that the treatment plan at issue was vague and unparticularized, and there was no justification as...

May 14, 2019

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C.S. v. Certas Home and Auto Insurance (18-003463)

The claimant was injured in an icy parking lot. She was a few feet from her vehicle when she slipped and fell. She applied for accident benefits. The insurer denied coverage on the basis that the incident was not an "accident" under the SABS. Adjudicator Ferguson concluded that the facts of loss were not an...

May 14, 2019

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J.M. v. Aviva General Insurance (17-007215)

The insurer sought reconsideration of the Tribunal's decision that catastrophic impairment assessments are payable outside of the medical benefits limits. Vice Chair Flude held that the Tribunal's decision did not contain a significant error of law, and was correct. He concluded that earlier FSCO decisions addressing the same issue were correct, and that catastrophic impairment...

May 14, 2019

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P.K. v. Certas Direct Insurance Company (18-003184)

The claimant twice adjourned a hearing, and then failed to attend the rescheduled hearing. The insurer sought a dismissal of the application. Adjudicator Parish granted the dismissal on the basis the claimant had abandoned the claim.

May 13, 2019

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W.H. v. Allstate Insurance (18-004037)

The claimant sought entitlement to three treatment plans for further physical therapy, assistive devices, and a chronic pain treatment program. Adjudicator Boyce awarded some of the assistive devices and denied the remainder of the claim. He held further physical therapy was not reasonable and necessary for the claimant's impairment, and that the proposed chronic pain...

May 10, 2019

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N.F. v. North Blenheim Mutual Insurance Company (16-002606)

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

May 10, 2019

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A.F. v. North Blenheim Mutual Insurance Company (16-002336)

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

May 10, 2019

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G.S. v. Aviva General Insurance Company (17-004847)

The insurer sought reconsideration of the Tribunal's decision that the claimant's injuries fell outside of the MIG due to chronic pain. Vice Chair Mather dismissed the reconsideration and held that the Tribunal had not made a significant error in law and had not violated the rules of natural justice. The Tribunal had considered the medical...

May 10, 2019

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T.T. v. Aviva Insurance Company (17-002535)

The insurer sought reconsideration of the Tribunal's award of $300 in costs related to the failure to comply with production of documents. Vice Chair Kershaw granted the reconsideration. She held that the Case Conference Order did not provide a disclosure deadline for the production of documents, so the insurer was not in breach by delivering...

May 10, 2019

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A.F. v. North Blenheim Mutual Insurance Company (16-002336)

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

May 10, 2019

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A.F. v. North Blenheim Mutual Insurance Company (16-002336)

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

May 10, 2019

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A.F. v. North Blenheim Mutual Insurance Company (16-002336)

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

May 9, 2019

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V.M. v. Aviva General Insurance Company (17-007475)

The claimant sought reconsideration of the Tribunal's decision denying a claimed assessment. Vice Chair Barry denied the reconsideration, holding that the claimant failed to provide particulars as to the error in fact or law. Further, the reconsideration request was made outside of the time frame for making the request.

May 9, 2019

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N.R. v. Aviva Insurance Canada (17-00912)

The claimant sought removal from the MIG and entitlement to further physical therapy and a psychological assessment. Adjudicator Mather concluded that the claimant suffered from chronic pain syndrome, which adversely affected his wellbeing; the MIG did not apply to his injuries. Further physical therapy was awarded based on the goal of reducing pain and increasing...

May 8, 2019

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G.E. v. Co-operators General Insurance Company (18-007928)

The Tribunal ordered the insurer to produce the adjuster's log notes, the complete accident benefits file, and raw data from IE assessors. The insurer sought reconsideration. Vice Chair Batty dismissed the request, reasoning that the disputed orders were not decisions that finally disposed of the appeal.

May 8, 2019

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H.R. v. TD Insurance Meloche Monnex (18-004179)

The Tribunal granted the claimant's request to have two applications heard together. The insurer sought reconsideration. Vice Chair Batty dismissed the request on the basis that the Tribunal's order was not an order that finally disposed of an appeal. Because the proceeding was ongoing, the insurer could not yet seek reconsideration.

May 8, 2019

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S.R. v. Aviva Insurance Company (17-004556)

The claimant sought reconsideration of the Tribunal's decision that the IRB claim was not barred by the limitation period. The request was made more than 12 months after the Tribunal's decision. Vice Chair Batty dismissed the request, holding that it was made outside of the required time period, and that the LAT Rules did not...

May 8, 2019

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M.F.X. v. Certas Home and Auto Insurance Company (18-004282)

The claimant argued that he suffered a non-minor injury due to chronic pain and sought entitlement to further chiropractic treatment. Adjudicator Norris rejected the claims. He reviewed the six factors outlined by the American Medical Association Guides in determining whether the claimant suffered chronic pain syndrome. The claimant failed to submit evidence regarding any of...

May 8, 2019

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L.M. v. Certas Home and Auto Insurance Company (18-002240)

The claimant was involved in an accident in California and sought accident benefits from his father's policy. The insurer argued that the claimant was not an "insured person" because he was not a dependent of his father. Adjudicator Punyarthi agreed with the insurer. There was insufficient financial evidence provided by the claimant to determine whether...

May 7, 2019

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L.F. v. Allstate Insurance Company of Canada (18-004517)

The claimant sought removal from the MIG and entitlement to various medical benefits. Adjudicator Fricot concluded that the claimant sustained a predominantly minor injury, and that there was no exacerbation of pre-accident injuries. Adjudicator Fricot noted that the claimant returned to work on a full time basis after the accident, and that reports of pain...

May 7, 2019

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S.C. v. Aviva Insurance Canada (18-007005)

The claimant sought a request for reconsideration following a denied request to adjourn a hearing on consent. The Tribunal initially denied the adjournment request because there was no evidentiary basis to support the request. Associate Chair Batty granted the reconsideration request because the claimant submitted information that demonstrated compelling personal reasons why counsel could not...

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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