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 23, 2019

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J.R. v. RSA Insurance (18-000770)

The claimant sought removal from the MIG and entitlement to four medical benefits. Adjudicator Hamud concluded that the claimant suffered chronic pain syndrome and that his injuries did not fall within the MIG. The family physician's clinical notes and records supported the conclusion, and the IE physicians failed to fairly consider the claimant's reports of...

January 21, 2019

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Aviva General Insurance Company v. H.H. (17-007805)

The insurer sought repayment of NEBs accidentally paid to the claimant from four weeks after the accident rather than 26 weeks after the accident. Adjudicator Hamud concluded that the insurer was not entitled to repayment. He held that because the first payment of NEBs that was made in error was more than 12 months prior...

January 21, 2019

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T.T. v. Security National Insurance Company (18-002654)

The claimant sought entitlement to NEBs and medical benefits for physical therapy. Adjudicator Ferguson held that the claimant did not meet the "complete inability" test because her pain did not practically prevent her from engaging in her pre-accident activities. She continued to perform self-care, she received accommodations at college, and she had returned to a...

January 21, 2019

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S.P. v. Gore Mutual Insurance Company (17-003686)

The claimant applied for accident benefits one year after an accident. She sought entitlement to a treatment plan for physical therapy. The insurer denied the claim and argued that the claimant was barred from pursuing accident benefits due to her late application. Adjudicator Msosa held that the claimant provided a reasonable explanation for the late...

January 20, 2019

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R.G. v. State Farm Insurance (17-006934)

The claimant sought entitlement to a home modification assessment. The insurer agreed to pay for the assessment up to $2,000. The claimant argued that the cap did not apply to such assessments. Adjudicator Gosio agreed with the insurer and held that home accessibility and housing assessments were subject to the $2,000 cap on assessments.

January 18, 2019

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A.R. v. Aviva Insurance Company (18-000838)

The claimant sought entitlement to medical benefits for psychological services. Adjudicator Johal concluded that the claimant was entitled to the claimed benefits. He concluded that the psychological services assisted the claimant with strategies for coping with pain and physical symptoms. He also concluded that a psychological assessment was reasonable and necessary given that the insurer...

January 14, 2019

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J.S. v. Cooperators General Insurance Company (18-000007)

The claimant sought entitlement to IRBs, removal from the MIG, and two treatment plans. Adjudicator Norris rejected the claim for IRBs, but removed the claimant from the MIG and awarded the medical benefits for psychological and physical treatment. The claimant failed to attend an IE regarding IRBs, so was not entitled to IRBs between April...

January 14, 2019

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M.K. v. Waterloo Insurance (17-001265)

The claimant sought reconsideration of the Tribunal's decision that his injuries fell within the MIG. Associate Chair Batty held that the Tribunal did not make an error in its factual conclusions regarding the claimant's alleged psychological injuries or pre-existing conditions. The reconsideration was dismissed.

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...

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com