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.

September 3, 2019

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V.D. v. Unifund Assurance Company (17-005656)

The claimant sought reconsideration of the Tribunal's decision to reject her claims for a chronic pain program and a self-propelled lawn mower and snow blower. Adjudicator Paluch dismissed the reconsideration request. He concluded that the Tribunal had not misapprehended the evidence or erred in its legal analysis. The Tribunal was permitted to weigh the evidence...

September 3, 2019

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C.A. v. Intact Insurance Company (18-000579)

The claimant sought reconsideration of the Tribunal's denial of the cost of catastrophic impairment assessments. Adjudicator Lester held that section 25(1)(5) only obligates an insurer to pay the reasonable fees charged in connection with filling out the application for the catastrophic determination rather than the assessments themselves. She also agreed that the reasonable and necessary...

August 29, 2019

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K.A. v. TD Insurance Company (18-009613)

The insurer sought reconsideration of a motion order denying the request to adjourn the scheduled hearing. Associate Chair Batty dismissed the reconsideration because it was not related to a final order.

August 29, 2019

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C.S. v. Aviva Insurance Company (18-007039)

The claimant sought reconsideration of a motion order denying the request to strike the insurer's evidence. Associate Chair Batty dismissed the reconsideration because it was not related to a final order.

August 27, 2019

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Applicant v. Toronto Transit Commission (18-009821)

The claimant sought a determination that he suffered a catastrophic impairment as a result of the accident. Adjudicator Boyce agreed with the claimant and concluded that he suffered a Class 4 marked impairment in adaptation, as well as a WPI in excess of 55 percent. Although the claimant presented with multiple credibility issues, Adjudicator Boyce...

August 27, 2019

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M.F. v. The Personal Insurance Company (18-007929)

The insurer alleged that the claimant was not a passenger in the vehicle when the accident occurred and sought repayment of medical benefits paid on her behalf. Vice Chair Flude concluded that the insurer had the burden to prove that the claimant had made a wilful misrepresentation, and that the insurer failed to meet its...

August 26, 2019

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W.J.L. v. Security National Insurance Company (18-009896)

The claimant sought entitlement to NEBs, removal from the MIG, and medical benefits. Adjudicator Chakravarti held that the claimant failed to prove that he did not suffer a non-minor injury. The claimant's testimony was not credible, and there was lack of evidence that he sustained any impairment as a result of the accident. The claim...

August 26, 2019

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Applicant v. Gore Mutual Insurance Company (18-011978)

The claimant sought an order from the case conference adjudicator that his decision not to strike the insurer's preliminary issue was biased and requested that the adjudicator recuse himself. Adjudicator Mazerolle refused the request. He explained that his decision was based on the written submissions of both parties and that a reasonable person would not...

August 26, 2019

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G. I-F. v. Economical Insurance Company (19-001420)

The claimant sought reconsideration of a motion order denying the request to vary the hearing timetable. Associate Chair Batty dismissed the reconsideration because it was not related to a final order.

August 23, 2019

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C.B. v. Allstate Insurance Company of Canada (18-009967)

The insurer asked for an extension of time to serve a motion record in relation to the claimant's motion to exclude certain evidence from an upcoming hearing. Adjudicator Paluch granted the extension and vacated the scheduled hearing dates in order for the motion to be heard. He wrote that the insurer inadvertently failed to serve...

August 23, 2019

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G.L. v. TTC Insurance Company Limited (18-005322)

The claimant sought entitlement to five treatment plans. In addition to arguing that they treatment was reasonable and necessary, the claimant also argued that the insurer's denials of three medical benefits did not comply with section 38(8) of the SABS. Adjudicator Grant found that the proposed treatment was not reasonable and necessary due to the...

August 21, 2019

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Applicant v. Allstate Insurance (18-006253)

The claimant sought entitlement to over $24,000 in catastrophic impairment rebuttal reports. The insurer argued that dispute was statute barred. Adjudicator Grant held that catastrophic impairment assessments are not "benefits" and therefore not subject to the two year limitation period. Adjudicator Grant concluded that the proposed assessments were reasonable and necessary, and were therefore payable....

August 15, 2019

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T.A. v. Unifund Assurance Company (18-005029)

The claimant sought removal from the MIG and entitlement to three medical benefits. Adjudicator Reilly held that the claimant sustained soft tissue injuries falling within the definition of "minor injury". The claimant failed to provide any medical evidence from his family physician disputing the diagnoses of the IE assessors.

August 15, 2019

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M.N. v. Aviva Insurance Canada (18-006097)

The claimant sought reconsideration of the Tribunal's refusal to re-open her application for entitlement to certain psychological services. The claimant and the insurer had agreed to resolve entitlement to proposed psychological services that were proposed. The services proposed were to be provided by a psychologist at the Guideline rates. The claimant then incurred the treatment...

August 14, 2019

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L.G. v. Unifund (18-008089)

The claimant sought entitlement to over $15,000 for multidisciplinary catastrophic impairment assessments. The insurer denied the assessments because the claimant had exhausted her medical benefits limits. Adjudicator Victor held that the cost of catastrophic impairment assessments did not fall within the medical benefits limits. She held that the claimant had to prove that each assessment...

August 9, 2019

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S.A. v. Guarantee Insurance (18-002962)

The claimant sought reconsideration of the Tribunal's decision that he was not entitled to NEBs. He argued, among other things, that the Tribunal's refusal to allow closing arguments violated the rules of natural justice. Vice Chair Jovanovic agreed that the Tribunal breached the rules of natural justice by not allowing closing submissions. The Tribunal could...

August 9, 2019

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S.A. v. Guarantee Insurance (18-002962)

The claimant sought reconsideration of the Tribunal's decision that he was not entitled to NEBs. He argued, among other things, that the Tribunal's refusal to allow closing arguments violated the rules of natural justice. Vice Chair Jovanovic agreed that the Tribunal breached the rules of natural justice by not allowing closing submissions. The Tribunal could...

August 8, 2019

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F.F. v. Aviva Insurance Canada (18-002994)

The claimant sought entitlement to medical marijuana and the cost of an assessment. Adjudicator Grant awarded both claims. He accepted that medical marijuana was a superior reliever of pain, anxiety and depression for the claimant, and that it was being recommended by the claimant's family physician.

August 2, 2019

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D.M. v. Aviva Insurance Canada (17-006781)

The insurer sought reconsideration of the Tribunal's award of an orthopaedic assessment. Vice Chair Mather granted the reconsideration and denied the claimed assessment. She held that the Tribunal made a significant error of law in concluding that section 38(8) required a "clear and unequivocal" denial of the goods and services it was not agreeing to...

July 31, 2019

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M.A.A. v. RBC Insurance (18-004989)

The claimant sought entitlement to two treatment plans. Adjudicator Ferguson held that the treatment plans were not reasonable and necessary. The claimant's family physician did not support the need for further physical therapy and the IE assessor concluded that the claimant had met maximum medical recovery. The psychological assessment also was not reasonable because the...

July 31, 2019

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H.S. v. Aviva Insurance Canada (17-007384)

The claimant sought removal from the MIG and entitlement to four treatment plans for physical therapy. As a preliminary matter, the insurer sought to admit as evidence two addendum report authored after the production deadline. Adjudicator Harper refused to admit the addendum reports, reasoning that they could have been obtained much earlier, since the records...

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