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.

January 11, 2019

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R.S. v. Aviva Insurance Company (17-008532)

The claimant sought removal from the MIG and entitlement to various medical benefits. Adjudicator Norris concluded that the claimant suffered a minor injury. The claimant's family physician and the insurer's assessor came to the same conclusion that the claimant suffered soft tissue injuries and did not suffer chronic pain. The claimant's expert was not persuasive...

January 11, 2019

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F.A. v. Certas Home and Auto Insurance Company (18-000591)

The claimant sought removal from the MIG and entitlement to a psychological assessment. Adjudicator Ferguson held that the claimant suffered minor injuries. The claimant failed to prove evidence of a pre-existing condition, a chronic pain condition, or a psychological condition. He noted that the records from the family physician did not support the position advanced...

January 9, 2019

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S.J. v. Aviva Insurance Canada (17-008968)

The claimant sought removal from the MIG. Adjudicator Ferguson held that the claimant suffer a minor injury because he failed to prove that he suffered chronic pain as a result of the accident. Neither the claimant's doctor nor the insurer's assessors came to such a conclusion and the claimant continued to live a normal and...

January 9, 2019

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R.D. v. Wawanesa Mutual Insurance Company (18-000054)

The claimant sought removal from the MIG and three medical benefits for psychological and physical services. Adjudicator Norris held that the claimant suffered minor injuries. He noted that a partial muscle tear fell within the definition of "minor injury". He also wrote that the claimant's family physician's records did not show evidence of a psychological...

January 8, 2019

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Applicant v. Security National Insurance Company (18-001613)

The insurer sought an adjournment of the scheduled Case Conference to allow time for CAT assessment to be completed. The Tribunal refused the requested. Associate Chair Batty also refused the adjournment request, stating that the assessments need to be completed by the time of the Case Conference for the insurer to participate. The insurer's defence...

January 4, 2019

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Applicant v. Toronto Transit Commission (17-009121)

The claimant sought entitlement to NEBs, ACBs, medical benefits, and a special award. Adjudicator Boyce denied entitlement to NEBs and ACBs, but awarded two medical benefits for physiotherapy and chiropractic therapy. With regard to NEBs, the adjudicator noted that the claimant's grades increased after the accident, she did not require assistance with personal care more...

December 27, 2018

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Z.P. v. Guarantee Insurance (18-003753)

The claimant had requested an adjournment of a written hearing due to her counsel's unanticipated medical leave. The LAT refused the adjournment. On reconsideration, Vice Chair Trojek granted the adjournment and set new dates for the written hearing. She wrote that the Tribunal relied too heavily on a strict adherence with its rules and failed...

December 27, 2018

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H.A. v. State Farm Insurance (18-000409)

A written hearing had been scheduled to address the claims for medical benefits and removal from the MIG. The claimant failed to comply with production orders and did not file her written submissions. The claimant failed to participate in a Case Conference resumption. Adjudicator Boyce dismissed the matter as abandoned.

December 24, 2018

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M.G. v. The Guarantee Company of North America (17-008687)

The claimant sought entitlement to NEBs, ACBs, and various medical benefits. Adjudicators Punyarthi and Watt dismissed the claims. They held that the claimant continued to engage in most of her pre-accident activities, despite doing so with pain. They rejected the claimant's Form 1, as well as the invoicing provided by the claimant which appeared to...

December 21, 2018

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Applicant v. Intact Insurance Company (17-004109)

The insurer sought reconsideration of the Tribunal's order that the claimant was required to attend two Ies before the matter could proceed, in accordance with section 55. However, the Tribunal's decision included terms regarding the IEs; Intact disputed those terms. Vice Chair Shapiro upheld the terms imposed by the Tribunal. He concluded that the Tribunal...

December 21, 2018

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Applicant v. The Guarantee Company of North America (17-006956)

The claimant sought reconsideration of the Tribunal's decision that she was not entitled to payment for catastrophic impairment assessments. Vice Chair Shapiro upheld the decision. He wrote that the Tribunal accurately considered whether there was some objective evidence to suggest that the claimant may suffer a 55 percent WPI. The Tribunal found that further investigation...

December 21, 2018

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Applicant v. Intact Insurance Company (17-004109)

The insurer sought reconsideration of the Tribunal's order that the claimant was required to attend two Ies before the matter could proceed, in accordance with section 55. However, the Tribunal's decision included terms regarding the IEs; Intact disputed those terms. Vice Chair Shapiro upheld the terms imposed by the Tribunal. He concluded that the Tribunal...

December 19, 2018

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Applicant v. Aviva Insurance Canada (18-000725)

This is a preliminary hearing decision regarding whether the claimant was statute barred from proceeding with an application to the LAT for failure to attend a s. 44 examination. The claimant's position was that he was unable to attend further s. 44 assessments due to mental and physical health impairments. Adjudicator Watt held that the...

December 19, 2018

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Applicant v. Aviva General Insurance (17-004258)

The insurer sought reconsideration of the Tribunal's decision that the claimant could apply to the LAT to dispute a catastrophic impairment determination without any other benefits being in dispute. Vice Chair Flude rejected the insurer's arguments and held that the Insurance Act permitted the Tribunal to hear the claimant's dispute.

December 18, 2018

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Applicant v. Aviva Insurance Company (17-008198)

The claimant alleged that a stroke six weeks after the accident was caused by the accident. She sought entitlement to IRBs and an electric scooter. The parties agreed that the "but for" test was the appropriate test for causation. Adjudicator Parish concluded that the medical evidence did not prove that the stroke was caused by...

December 18, 2018

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J.E.C.L. v. Allstate Insurance Company of Canada (17-006909)

The claimant sought entitlement to NEBs and a chronic pain assessment. Adjudicator Boyce concluded that the claimant's activities remained largely the same after the accident. Although he suffered from pain, he was not practically prevented from the majority of his activities. Adjudicator Boyce also noted that the claimant failed to prove that his reported injuries...

December 17, 2018

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J.R. v . Coachman Insurance Company (17-001337 and 17-001154)

The claimant was involved in a major 2002 workplace accident and was then in two motorcycle accidents in 2011 and 2012. The claimant applied to the LAT seeking a determination that he sustained a catastrophic impairment as a result of one or both of the motor vehicle accidents. Adjudicator Shapiro found that the claimant was...

December 13, 2018

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K.W. v. Certas Direct Insurance Company (17-008502)

The claimant sought entitlement to two treatment plans for physical therapy. Adjudicator Ferguson dismissed both claims. He held that the claimant had reached maximum medical improvement and that the claimant had returned to a high degree of function. Furthermore, the claimant was not reporting pain relief as a result of passive physical therapy.

December 11, 2018

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M.Y. v. Aviva Insurance Company (17-007683)

The Insurer filed a Request for Reconsideration of a hearing decision that allowed the claimant to proceed with her application despite non-attendance at insurer examinations requested under s. 44 of the SABS. The hearing adjudicator had ordered the respondent to attend the insurer examinations as a condition to allowing the claimant to proceed. The insurer...

December 11, 2018

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C.C. v. Economical Insurance Co. (18-003633)

The claimant sought entitlement to IRBs; the insurer argued that the dispute was barred by the limitation period. Adjudicator Ferguson agreed with the insurer and held that the denial of IRBs had been more than two years prior to the LAT application, and that the denial was clear and unequivocal. The claimant's argument that he...

December 11, 2018

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D.S. v. Wawanesa Mutual Insurance Company (17-008334)

The claimant sought entitlement to medical benefits for various dental work. Adjudicator Norris concluded that the dental work was partly reasonable and necessary. He also concluded that the claimant did not need to submit the dental work on an OCF-18. The awarded dental work related only to the teeth that were damaged in the accident....

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP