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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November 16, 2018

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H.C. v. Allstate Insurance Company (17-007262)

The claimant was in an accident in August 2016. He argued that the pre-June 1, 2016 definition of catastrophic impairment should apply to his claim because his policy had not renewed. Adjudicator Neilson disagreed with the claimant and held that section 2 of the SABS unambiguously stated that the new catastrophic impairment definition applied to...

November 13, 2018

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Applicant v. Aviva Insurance Canada (17-003957)

The claimant sought entitlement to medical benefits for physical and psychological therapy. Adjudicator Goela awarded all of the claimed benefits. She held that the claimant suffered from chronic pain and psychological injuries. She relied upon the records of the family physician which supported the need for ongoing treatment.

November 8, 2018

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L.J. v. The Personal Insurance Company (17-004701)

The claimant sought an order removing the insurer's counsel because the same counsel had acted for the insurer in the priority dispute. The claimant also sought to exclude the transcripts from the priority examination under oath. Vice Chair Trojek granted reconsideration and barred counsel from representing the insurer in the LAT dispute. She also barred...

November 8, 2018

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P.Y.J. v. The Personal Insurance Company (17-004636)

The claimant sought an order removing the insurer's counsel because the same counsel had acted for the insurer in the priority dispute. The claimant also sought to exclude the transcripts from the priority examination under oath. Vice Chair Trojek granted reconsideration and barred counsel from representing the insurer in the LAT dispute. She also barred...

November 7, 2018

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J.M. v. Certas Home and Auto Insurance Company (18-001406)

The claimant was involved in an accident in 1997. She applied for a catastrophic impairment determination in 2007, which found that she did not meet the definition. She did not dispute the determination. In 2016 she submitted a new OCF-19 seeking a catastrophic impairment determination and sought payment for assessments in that regard. The insurer...

October 31, 2018

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H.M. v. Aviva Insurance Canada (17-005588)

The claimant sought entitlement to IRBs. The only issue in dispute was the quantum of IRBs payable. The claimant submitted that she earned $1,500 gross income in the 4 weeks pre-accident whereas the insurer submitted that based on the evidence, the claimant earned $700 gross income in the 4 weeks pre-accident. Adjudicator Neilson found that...

October 31, 2018

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P.F. v. Aviva Insurance (18-002458)

The claimant sought entitlement to NEBs. Adjudicator Boyce held that the claimant did not demonstrate a complete inability to live a normal life. Adjudicator Boyce held that while the claimant's pain affected her activities of daily living, it did not prevent her from independent self-care or complete engagement in her daily activities. Adjudicator Boyce noted...

October 31, 2018

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Intact Insurance Company v. Lanziner-Brackett (2018 ONSC 6546)

The insurer sought judicial review of the Tribunal's decision that the claimant was involved in an accident, and also sought judicial review of the Case Conference adjudicator's framing of the dispute. The claimant had been struck by the door of a vehicle twice, and then physically assaulted by the driver of the vehicle. The insurer...

October 30, 2018

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N.B. v. Aviva Insurance Canada (17-006736)

The claimant sought entitlement to NEBs and various medical/rehabilitation benefits. The hearing proceeded in-person and by writing. Adjudicator Boyce concluded that the claimant did not suffer a complete inability to carry on a normal life. Adjudicator Boyce noted that while the claimant's injuries prevented her from returning to some of her pre-accident activities of daily...

October 30, 2018

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M.G. v. RBC Insurance Company (17-007098)

The claimant disputed his entitlement to NEBs and various medical/rehabilitation benefits. The dispute proceeded by way of a written hearing. Adjudicator Boyce held that while the claimant suffered from pain, the claimant managed his pain and it did not prevent the claimant from engaging in self-care and in his daily activities. Adjudicator Boyce noted that...

October 29, 2018

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P.P. v Portage La Prairie Mutual Insurance Company (17-008689)

The claimant disputed her entitlement to eight treatment and assessment plans and post-104 week IRBs. Adjudicator Kershaw awarded all of the medical benefits in dispute, save for a portion of a treatment plan that sought funding for a weighted vest. With respect to the weighted vest, Adjudicator Kershaw agreed with the IE neurologist's opinion that...

October 29, 2018

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E.S. v Aviva Insurance Canada (18-000456)

The claimant sought entitlement to the balance of a partially approved chronic pain assessment treatment plan and interest. Adjudicator Victor awarded the balance of the treatment plan, less transportation expenses, and interest on the overdue payment of benefits. Adjudicator Victor noted that she arrived at her decision largely in part due to the claimant's credibility...

October 29, 2018

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J.T. v Western Assurance Company (17-008140)

The claimant sought entitlement to treatment outside of the MIG and various medical benefits. Adjudicator Victor held that the claimant's injuries fell within the MIG and that the disputed medical benefits were not payable. With respect to the claimant's submissions that she suffered from chronic pain, Adjudicator Victor held that as the claimant's pain did...

October 25, 2018

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F.F. v. Aviva Insurance (17-005772)

The claimant sought entitlement to NEBs. Adjudicator Ferguson held that the claimant did not meet the "complete inability" test. He found the IE reports persuasive and noted that the claimant did not make any substantive criticism of the IE reports with respect to methodology or the characterization of his self-reporting. Furthermore, assertions in the claimant's...

October 25, 2018

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G.L. v. Security National Insurance Company (18-002099 and 18-004400)

The Case Conference adjudicator listed repayment of non-earner benefits as an issue in dispute. The claimant brought a motion seeking to remove repayment as an issue. Vice Chair Hunter concluded that he did not have jurisdiction to alter the Case Conference Order, and that the claimant should have sought reconsideration. However, he did order the...

October 24, 2018

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Applicant v. Aviva General Insurance (17-008268)

The claimant sought entitlement to a chronic pain assessment. Adjudicator Ferguson held that the claimant failed to prove entitlement. He noted that the claimant was not diagnosed with chronic pain by any independent medical assessors, nor had the risk of chronic pain been raised with any independent assessors. The claimant also failed to explain why...

October 19, 2018

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M.K. v. Certas Direct (17-006932)

The claimant sought removal from the MIG and entitlement to two treatment plans for psychological therapy. Adjudicator Grant concluded that the claimant did not suffer a psychological injury related to the accident. He further noted that the claimant indicated that he was unlikely to find psychological treatment helpful.

October 18, 2018

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R.A. v. The Guarantee Company of North America (17-006363)

The claimant sought removal from the MIG and entitlement to two treatment plans for physical therapy. Adjudicator Ferguson held that the claimant's injuries fell within the MIG. He held that the claimant's lower back pain was not caused by the accident, but rather after lifting something heavy. He also noted that the claimant did not...

October 17, 2018

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P.F. v. Aviva General Insurance Company (formerly RBC Insurance) (17-006863)

The claimant sought entitlement to IRBs. The insurer argued that the limitation period applied. Adjudicator Harmison concluded that the claimant was time-barred from seeking IRBs. She held that the insurer clearly told the claimant that he did not qualify for IRBs in its response to his OCF-1. The insurer also set out the two year...

October 17, 2018

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M.B. v. Travellers Insurance Company (17-006174)

The claimant was injured while driving an off-road vehicle (a dirt bike) at a closed course competition. The insurer denied that an "accident" had occurred because the off-road vehicle was not an "automobile." Adjudicator Kowal agreed with the insurer and held that because the dirt bike was exempt from the requirement to be insured under...

October 12, 2018

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A.S. v. Aviva Canada Inc. (18-001273)

The claimant sought entitlement to a special award. The insurer had requested an OCF-10 Election based on the Disability Certificate supporting both IRBs and NEBs. The claimant argued that it was unnecessary, but later submitted an Election. The insurer agreed to pay IRBs from the date of the Disability Certificate. The claimant argued that she...

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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