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 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.

October 11, 2019

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Applicant v. Portage La Prairie Mutual Insurance Company (18-001837)

The claimant sought entitlement to NEBs and a special award. Adjudicator Grieves awarded NEBs from the date of termination onwards. She noted that the claimant suffered ongoing cognitive impairments in multiple domains. Consistent with Heath v. Economical, the claimant was prevented from engaging in the pre-accident activities that were most important to him. Adjudicator Grieves...

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.

October 10, 2019

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Maeghan Easson v. Aviva Insurance Canada (18-011969)

The claimant sought an order reinstating payment of IRBs. The insurer argued that the claimant failed to provide relevant documents which had been requested under section 33. Adjudicator Go held that the insurer's request for employment information and medical records were reasonable, and that the claimant failed to provide any explanation as to why it...

October 10, 2019

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J.L.C. v. RBC Insurance Company (18-007281)

The claimant sought removal from the MIG and entitlement to chiropractic treatment and a chronic pain assessment. Adjudicator Hines concluded that the claimant's injuries fell under the MIG. The claimant provided no evidence as to how his injuries interfered with his job, and there were few references to pain in his family physician's records. There...

October 10, 2019

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D.G. v. Wawanesa Mutual Insurance Company (18-004667)

The claimant sought removal from the MIG and entitlement to two medical benefits for psychological treatment. Adjudicator Norris concluded that the claimant suffered from psychological injuries as a result of the accident, which removed him from the MIG. The proposed medical benefits were found reasonable and necessary.

October 10, 2019

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I.M.N. v. Intact Insurance Company (18-005359)

The claimant sought reconsideration of the Tribunal's decision that he was not entitled to accident benefits. The claimant had applied for benefits under Quebec's SAAQ. He later filed an application for SABS benefits when he was unhappy with the SAAQ benefits. The Tribunal rejected the claimant's arguments, stating that he was simply re-arguing the same...

October 10, 2019

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I.M.N. v. Intact Insurance Company (18-005359)

The claimant sought reconsideration of the Tribunal's decision that he was not entitled to accident benefits. The claimant had applied for benefits under Quebec's SAAQ. He later filed an application for SABS benefits when he was unhappy with the SAAQ benefits. The Tribunal rejected the claimant's arguments, stating that he was simply re-arguing the same...

October 9, 2019

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A.B. v. Guarantee Insurance (18-010371)

The claimant sought entitlement to medical benefits for physical and psychological treatment. Adjudicator Braun found all three medical benefits reasonable and necessary. In terms of physical therapy, the claimant showed consistent improvement with same. In terms of psychological therapy, Adjudicator Braun accepted that 1.5 hour sessions were appropriate for the claimant.

October 9, 2019

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J.A.A. v. Aviva General Insurance Company (18-008671)

The claimant sought entitlement to one treatment plan for chiropractic treatment. Adjudicator Boyce held that it was not reasonable and necessary. He found the denial complied with section 38, and found that clinic based treatment was not helping the claimant's function improve.

October 9, 2019

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S.B. v. Aviva Insurance Company (17-001414)

The claimant sought reconsideration of the Tribunal's decision that his injuries fell within the MIG and that he was not entitled to claimed medical benefits. The issue of the MIG was accidentally included in the LAT application, and the claimant had been removed from the MIG prior to the hearing based on an IE. Adjudicator...

October 8, 2019

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D.R. v. Aviva Insurance Canada (18-007848)

The claimant sought entitlement to NEBs. Adjudicator Watt dismissed the claim. He found the claimant's testimony to conflict with the medical records. He also wrote that the surveillance of the claimant contradicted his reported abilities. The medical reports from the claimant's experts relied on the claimant's self-reporting, which was held not to be accurate.

October 8, 2019

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I.D.C. v. Aviva Insurance Canada (17-004536)

The claimant sought entitlement to NEBs, removal from the MIG, and various medical benefits. She alleged that the accident aggravated injuries from an earlier accident. Adjudicator Sharda held that the claimant suffered from pre-existing psychological impairments and chronic pain, which were worsened by the accident, and entitled to her treatment outside of the MIG; further...

October 8, 2019

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Motor Vehicle Accident Claims Fund v. I.G. (18-000798)

The Fund sought repayment of IRBs and medical benefits, arguing that the claimant was not employed at the time of the accident and was not involved in a motor vehicle accident as claimed. Adjudicator Makhamra accepted that the claimant had committed a wilful misrepresentation. A few years after initially making the accident benefits claim, the...

October 7, 2019

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D.M. v. Aviva General Insurance Company (18-003850)

The claimant sought entitlement to three medical benefits. The insurer approved the treatment plans shortly after written submissions were due. Adjudicator Norris held that interest was also payable on the treatment plans from the date of the LAT application onwards.

October 7, 2019

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B.H. v. Certas Home and Auto Insurance Company (17-006967)

The insurer sought reconsideration of the Tribunal's decision that the denial letter for a psychological assessment was deficient and that the insurer was barred from applying the MIG; the assessment was also found reasonable and necessary. Vice Chair Lester dismissed the reconsideration. She held that the Tribunal had not violated the rules of procedural fairness...

October 4, 2019

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E.G. v. Wawanesa Insurance (18-010183)

The claimant sought removal from the MIG and entitlement to two medical benefits. Adjudicator Grant concluded that the claimant suffered minor injuries. There was no evidence of pre-existing conditions, psychological impairments, or chronic pain syndrome.

October 4, 2019

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W.P. v. Travelers Insurance (18-010458)

The claimant sought removal from the MIG and entitlement to two medical benefits. Adjudicator Grant concluded that the claimant suffered minor injuries. There was no evidence of impairments falling outside of the MIG definition.

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416.507.1850

eodonnell@tgplawyers.com

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com