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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September 13, 2018

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Aviva General Insurance v. Respondent (17-007666)

The insurer sought repayment of IRBs; the claimant sought entitlement to further IRBs. Adjudicator Kershaw held that the insurer was entitled to repayment of IRBs for the period the claimant was receiving disability benefits from Co-operators Insurance (Edge). She concluded that the Edge benefits were an income continuation plan, and that it was irrelevant whether...

September 6, 2018

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Applicant v. Aviva Insurance (18-000467)

The claimant sought entitlement to a mental health assessment. The insurer had requested the claimant's attendance at an IE to address. The claimant attended the IE but it did not proceed because the claimant wishes to record the IE. The insurer argued that section 55 barred the claimant from seeking entitlement at the LAT. Adjudicator...

September 6, 2018

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B.H. v. Aviva Canada Inc. (17-003774)

The claimant sought reconsideration of the Tribunal's decision that he could not proceed with his application due to failure to attend an IE. Executive Chair Lamoureux held that the insurer's denial of medication benefits and subsequent request for an IE did not comply with sections 38 and 44 of the SABS. She wrote that the...

September 5, 2018

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Applicant v. Aviva Insurance Canada (17-005791)

The claimant sought removal from the MIG and entitlement to four treatment plans. Adjudicator Johal concluded that the claimant's psychological injuries fell outside of the MIG, and the claimant was entitled to all four treatment plans. The insurer's assessor acknowledged that the claimant's emotional condition was significantly affecting her ability to function effectively, but did...

August 31, 2018

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Applicant v The Guarantee Company of North America (17-004229)

The claimant sought entitlement to IRBs post 104 weeks and a special award. Adjudicator Neilson held that the claimant was not entitled to IRBs after 104 weeks. The adjudicator held that the employment identified by the insurer's vocational specialist was reasonably suited by the claimant's education, training and experience; the claimant had not made a...

August 29, 2018

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Applicant v Motor Vehicle Accident Claims Fund (17-007244)

The claimant sought medical benefits for physical rehabilitation and chiropractic services, and interest on the overdue payment of benefits. Adjudicator Pinto held that the treatment plans in dispute were not reasonable and necessary and that there was insufficient objective medical evidence to support the treatment plans. Adjudicator Pinto preferred the insurer's evidence that the claimant,...

August 28, 2018

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Applicant v Wawanesa Mutual Insurance Company (17-007887)

The claimant disputed the insurer's MIG determination and sought medical benefits for psychological assessment, psychological treatment, and chiropractic treatment, as well as a special award. Adjudicator Grant held that the claimant's injuries were subject to treatment within the MIG and it was unnecessary to consider whether the treatment plans were reasonable and necessary. The claimant...

August 28, 2018

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Z.A. v Aviva Insurance Canada (17-008789)

The claimant sought entitlement to the costs of examination for an in-home assessment, attendant care benefits, and a special award. Adjudicator Norris held that the claimant was unsuccessful on all issues. The adjudicator held that the cost of an in-home assessment was not payable as it was incurred prior to submitting a treatment and assessment...

August 28, 2018

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Applicant v. Scottish & York (17-006460)

The claimant sought entitlement to a psychological assessment and chronic pain treatment. Adjudicator Victor held that the claimant was entitled to the medical benefits as they were reasonable and necessary. The claimant demonstrated consistent psychological symptoms throughout a pre-screening and two IEs. While the claimant only received a formal diagnosis from the second IE, the...

August 28, 2018

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

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the...

August 28, 2018

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O.S. v. Certas Direct Insurance Company (17-007412)

The claimant sought entitlement to one treatment plan for chiropractic and physiotherapy services. Adjudicator Cavdar found that the treatment plan in dispute was not reasonable and necessary as a result of the accident and not payable. Adjudicator Cavdar found that the treatment plan was related to a post-accident workplace injury rather than the motor vehicle...

August 27, 2018

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Y.I. v. Aviva Canada Inc. (18-0005452)

The claimant sought entitlement to chiropractic, massage, and physiotherapy treatment proposed in four treatment plans. Adjudicator Johal found that the claimant was entitled to the cost of two of the treatment plans in dispute, based on a detailed analysis of the OCF-18 forms and the IE assessments. Adjudicator Johal found that the IE assessor did...

August 27, 2018

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M.C. v Certas Home and Auto Insurance (17-005243)

The claimant failed to attend a case conference which was the fourth proceeding he failed to attend. The claimant was put on notice that his application could be dismissed as abandoned and was given an opportunity to provide written submissions on why his application should not be dismissed without a hearing. The claimant failed to...

August 27, 2018

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B.A. v. Gore Mutual Insurance Company (18-000290)

The claimant sought coverage for accident benefits following an assault at an auto mechanic. The insurer denied that the facts of loss constituted an accident. Adjudicator Mazerolle agreed with the insurer. He conceded that attending an auto mechanic was part of the ordinary and well-known activities to which an automobile is put. He also conceded...

August 24, 2018

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Applicant v. Unifund Assurance Company (17-004579)

The claimant sought a determination that her impairments were outside of the MIG and entitlement to attendant care and medical benefits proposed in eight treatment plans. Adjudicator Go found that the claimant's injuries fell within the MIG and she was not entitled to any of the benefits in dispute. As a preliminary issue, the respondent...

August 24, 2018

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Applicant v Unifund Insurance Company (17-009004)

The insurer requested reconsideration of part of a decision made by external counsel for the Tribunal during a case conference. At the case conference, the insurer requested the determination of the preliminary issue of whether the claimant was precluded from proceeding with his application to the LAT because he failed to attend IEs. External counsel...

August 23, 2018

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Applicant v Aviva General Insurance (17-003692)

The claimant argued that her injuries including chronic pain syndrome, psychological impairments, jaw injury, and post-traumatic headaches fell outside the MIG and sought medical benefits and the costs of examinations. Adjudicator Daoud held that the claimant suffered from minor injuries that fell within the MIG. The adjudicator found that claimant did not suffer from chronic...

August 22, 2018

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Applicant v Aviva Insurance Canada (17-008143)

The claimant sought entitlement to IRBs, medical benefits, and various costs of examinations, in addition to a special award. Adjudicator Fricot held that the claimant was not entitled to any of the benefits claimed. The claimant argued that all documentation submitted by the insurer be ruled inadmissible as it was not sworn, or that it...

August 22, 2018

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Applicant v. The Co-Operators General Insurance Company (17-006816)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to one treatment plan for psychological services. This was the claimant's second LAT application relating to MIG determination. The adjudicator in the hearing relating to the first application (Adjudicator Sewrattan) found that the claimant's injuries were minor. When the second...

August 21, 2018

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

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the...

August 21, 2018

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Applicant v. Aviva Insurance Canada (17-006138)

The claimant sought entitlement to two treatment plans for chiropractic and psychological services. Adjudicator Watt found that the claimant was not entitled to the benefits in dispute. Adjudicator Watt found that many of the medical complaints raised by the claimant were not connected to the 2013 motor vehicle accident. Adjudicator Watt found that the treatment...

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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