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.

May 10, 2019

/

tgp-admin

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

The claimant sought reconsideration of the Tribunal's decision that he was barred from seeking entitlement to certain benefits due to the limitation period. In particular, he argued that section 7 of the LAT Act applied in extending the time by which he had to apply to the LAT. Vice Chair Kershaw granted the reconsideration and...

May 9, 2019

/

tgp-admin

V.M. v. Aviva General Insurance Company (17-007475)

The claimant sought reconsideration of the Tribunal's decision denying a claimed assessment. Vice Chair Barry denied the reconsideration, holding that the claimant failed to provide particulars as to the error in fact or law. Further, the reconsideration request was made outside of the time frame for making the request.

May 9, 2019

/

tgp-admin

N.R. v. Aviva Insurance Canada (17-00912)

The claimant sought removal from the MIG and entitlement to further physical therapy and a psychological assessment. Adjudicator Mather concluded that the claimant suffered from chronic pain syndrome, which adversely affected his wellbeing; the MIG did not apply to his injuries. Further physical therapy was awarded based on the goal of reducing pain and increasing...

May 8, 2019

/

tgp-admin

G.E. v. Co-operators General Insurance Company (18-007928)

The Tribunal ordered the insurer to produce the adjuster's log notes, the complete accident benefits file, and raw data from IE assessors. The insurer sought reconsideration. Vice Chair Batty dismissed the request, reasoning that the disputed orders were not decisions that finally disposed of the appeal.

May 8, 2019

/

tgp-admin

H.R. v. TD Insurance Meloche Monnex (18-004179)

The Tribunal granted the claimant's request to have two applications heard together. The insurer sought reconsideration. Vice Chair Batty dismissed the request on the basis that the Tribunal's order was not an order that finally disposed of an appeal. Because the proceeding was ongoing, the insurer could not yet seek reconsideration.

May 8, 2019

/

tgp-admin

S.R. v. Aviva Insurance Company (17-004556)

The claimant sought reconsideration of the Tribunal's decision that the IRB claim was not barred by the limitation period. The request was made more than 12 months after the Tribunal's decision. Vice Chair Batty dismissed the request, holding that it was made outside of the required time period, and that the LAT Rules did not...

May 8, 2019

/

tgp-admin

M.F.X. v. Certas Home and Auto Insurance Company (18-004282)

The claimant argued that he suffered a non-minor injury due to chronic pain and sought entitlement to further chiropractic treatment. Adjudicator Norris rejected the claims. He reviewed the six factors outlined by the American Medical Association Guides in determining whether the claimant suffered chronic pain syndrome. The claimant failed to submit evidence regarding any of...

May 8, 2019

/

tgp-admin

L.M. v. Certas Home and Auto Insurance Company (18-002240)

The claimant was involved in an accident in California and sought accident benefits from his father's policy. The insurer argued that the claimant was not an "insured person" because he was not a dependent of his father. Adjudicator Punyarthi agreed with the insurer. There was insufficient financial evidence provided by the claimant to determine whether...

May 7, 2019

/

tgp-admin

L.F. v. Allstate Insurance Company of Canada (18-004517)

The claimant sought removal from the MIG and entitlement to various medical benefits. Adjudicator Fricot concluded that the claimant sustained a predominantly minor injury, and that there was no exacerbation of pre-accident injuries. Adjudicator Fricot noted that the claimant returned to work on a full time basis after the accident, and that reports of pain...

May 7, 2019

/

tgp-admin

S.C. v. Aviva Insurance Canada (18-007005)

The claimant sought a request for reconsideration following a denied request to adjourn a hearing on consent. The Tribunal initially denied the adjournment request because there was no evidentiary basis to support the request. Associate Chair Batty granted the reconsideration request because the claimant submitted information that demonstrated compelling personal reasons why counsel could not...

May 7, 2019

/

tgp-admin

L.S. v. Guarantee Insurance (18-004105)

The claimant brought a motion to exclude the transcripts from the criminal proceeding. Adjudicator Maedel dismissed the motion, holding that admissibility of evidence was to be left to the hearing adjudicator subject to relevance, privilege, or inadmissibility.

May 6, 2019

/

tgp-admin

J.V. v. Economical Insurance Company (18-001145)

The claimant sought reconsideration of the adjudicator's preliminary decision that IRBs and ACBs were statute barred and would not be addressed in the hearing. It was clear from review of the adjudicator's decision that ACBs were not meant to be statute-barred, and the typographical error in the decision was amended pursuant to Rule 19. The...

May 3, 2019

/

tgp-admin

J.D.S. v. Aviva Insurance Canada (18-002529)

The claimant sought entitlement to a speech language pathology assessment. He failed to attend an IE scheduled by the insurer; the insurer argued that the claimant was barred from applying to the LAT in accordance with section 55. Adjudicator Johal agreed with the insurer and concluded that section 55 applied. The IE notice provided the...

May 1, 2019

/

tgp-admin

L.V.D. v. Aviva Insurance Company of Canada (18-001286)

The claimant sought entitlement to three treatment plans and removal from the MIG. Adjudicator Mazerolle concluded that the claimant suffered a minor injury, and was not entitled to further medical benefits. He noted that the claimant had returned to pre-accident activities, and did not suffer from chronic pain or psychological impairment.

May 1, 2019

/

tgp-admin

E.D. v. Aviva General Insurance Company (18-002597)

The claimant sought entitlement to the remainder of a partially approved treatment plan for physical therapy and gym equipment, and a special award. Adjudicator Lake awarded the remainder of the treatment plan, but declined to grant a special award. She held that the proposed treatment was reasonable for pain reduction, increase in strength and range...

April 30, 2019

/

tgp-admin

V.D. v. Aviva Insurance Canada (18-007435)

This is a preliminary issue decision addressing the following issues: 1) whether the claimant was statute barred from applying to the LAT for non-earner benefits for failure to attend a s. 44 OT assessment, and 2) whether the claimant was barred from proceeding with her claim for payment of a psychological assessment. Adjudicator Ferguson held...

April 30, 2019

/

tgp-admin

R.T. v. The Economical Group (17-008069)

The claimant was catastrophically impaired as a result of an accident and sought a determination that she was entitled to receive home modifications and home devices in the amount of $415,334.00. The insurer agree that home renovations were required but disputed the scope and quantum of the proposed benefits. Adjudicator Grieves found that the proposed...

April 29, 2019

/

tgp-admin

V.K. v. Unica Insurance Inc. (18-007227)

This is a preliminary issue decision on whether the cost of assessments to determine catastrophic impairment falls within the $50,000.00 limit on medical and rehabilitation benefits. Adjudicator Ferguson concurred with previous decisions that CAT assessments are not a benefit, and found that the insurer is obliged to pay the full cost of CAT assessments subject...

April 29, 2019

/

tgp-admin

D.S. v. The Personal Insurance Company (18-001204)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to a s. 25 psychology assessment. The insurer raised the preliminary issue of whether the claimant was statute barred from applying to the LAT for the psychology assessment because he failed to attend a s. 44 examination. The claimant was...

April 26, 2019

/

tgp-admin

D.0. v. Primmum Insurance Company (18-001673)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to two treatment plans for physiotherapy. The claimant submitted that the he developed chronic pain as a result of the accident. In support of his position, he relied on three OCF-3s, a s. 25 chronic pain report, and family doctor...

April 26, 2019

/

tgp-admin

H.K. v. The Commonwealth Mutual Insurance Group (18-005647)

The claimant sought production of log notes from the date of the first FSCO arbitration application up to the date of the LAT application. The insurer argued that these notes were protected by privilege. Adjudicator Fricot concluded that the log notes between the date of the FSCO arbitration application up to the date of the...

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP Disclaimer | Privacy Policy | Statement of Principles

Powered by Crow & Pitcher

Subscribe to get TGP’s case summaries straight to your inbox

Subscribe to get TGP’s case summaries straight to your inbox

Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP