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 16, 2019

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P.Y. v Aviva General Insurance Company (17-003692)

The claimant sought reconsideration of the Tribunal's decision based on there being new evidence that the claimant could not have reasonably obtained earlier and based on the insurer's concession at the close of the proceedings that the MIG did not apply. Adjudicator Grieves granted the claimant's reconsideration request. Adjudicator Grieves accepted that the new evidence,...

September 16, 2019

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F.J.H. v. Unica Insurance Inc. (18-008249)

The claimant disputed his entitlement to a medical benefit and the MIG. Adjudicator Lester held that the claimant's injuries fell within the MIG and that he was not entitled to the disputed medical benefit. Adjudicator Lester held that while the claimant suffered from pain and poor sleep pre-accident, the claimant had not submitted compelling evidence...

September 16, 2019

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L. Y. v Aviva Insurance Company (17-008847)

The insurer sought reconsideration of the Tribunal's decision, arguing that it had made a significant error of law or fact by referring to evidence not before it, placed the onus on the insurer, and failing to adhere to case law. On reconsideration, Adjudicator Norris held that he did not err in law in his decision....

September 13, 2019

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H.M. v. Aviva Insurance Canada (18-004734)

The claimant sought reconsideration of the Tribunal's decision finding that he was not entitlement to Non-Earner Benefits. Upon receipt of the reconsideration request, the Tribunal invited both parties to submit supplementary submissions. Neither party delivered supplementary submissions. Adjudicator Lake dismissed the claimant's request for reconsideration. Adjudicator Lake found that the claimant's request for reconsideration was...

September 11, 2019

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Travelers Insurance v. C.B. (18-007878)

The insurer sought repayment of IRBs paid to the claimant for a period she was working in a job with similar job duties to her pre-accident employment. Adjudicator Paluch granted repayment of $13,134.06 in IRBs. He held that the claimant's return to work suggested that she did not suffer a substantial inability to engage in...

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...

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...

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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

416.507.1850

eodonnell@tgplawyers.com