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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May 30, 2017

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Applicant v. Waterloo Regional Municipalities Insurance (16-000066)

This reconsideration was requested by the insurer after the claimant's request for reconsideration of a decision was rejected. In this matter, Executive Chair Lamoureux reviewed the purpose of costs at the LAT and the meaning of "frivolous" and "vexatious," and declined the insurer's requests for costs.

May 29, 2017

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S.L.L. v. Certas Home and Auto Insurance Company (16-000213)

One day before the scheduled hearing, the claimant's counsel notified the LAT and the insurer that the claimant had travelled to China for a family emergency. The hearing was adjourned to a later date, which neither the claimant nor his counsel attended. The insurer sought the dismissal of the claim as abandoned. Adjudicator Gottfried held...

May 29, 2017

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Applicant v. Unica Insurance Inc. (16-000372)

The claimant sought entitlement to attendant care benefits. Her claim was dismissed at a hearing. The claimant applied for reconsideration. It was alleged the Tribunal denied procedural fairness by conducting the original hearing by writing. Executive Chair Linda Lamoureux noted that neither party originally objected to proceeding by way of writing. After reviewing the matter,...

May 26, 2017

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Y.S. v. The Guarantee Company of North America (17-000781)

The claimant failed to participate in the initial LAT Case Conference or the resumed Case Conference. Adjudicator Markovits dismissed the claim over the objections of the claimant's counsel.

May 26, 2017

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Applicant v. Wawanesa Mutual Insurance Company (16-000324)

Following the claimant's success in entitlement to a claimed medical benefit, the insurer sought reconsideration on the basis that the LAT adjudicator should not have admitted late medical documents. Executive Chair Lamoureux held that the Tribunal maintained the discretion to admit any late materials. Further, she wrote that the insurer should have objected to the...

May 24, 2017

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H.A. v. Unifund Assurance Company (16-002037)

This claim was dismissed by Adjudicator Hines after the claimant failed to make any written submissions or provide any evidence supporting his IRB claim.

May 24, 2017

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Amorouso v. The Co-operators General Insurance Company (17-001327)

The insurer sought direction on the release of a preliminary issue hearing decision as to whether the release would impact a looming hearing. Vice Chair Hunter determined that since the release of the preliminary decision would unlikely be before the hearing, the looming hearing was cancelled and set for rescheduling.

May 23, 2017

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Applicant v. Intact Insurance Company (16-003927)

The claimant had requested an adjournment of a hearing scheduled for July 2017 to be moved to November 2017 to allow the parties to attend a global mediation. The Case Management Officer (CMO) had denied the request. Following the denial, the claimant's counsel also told the LAT that their expert witness would be on vacation...

May 19, 2017

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Applicant v. Aviva Insurance Company (16-000670)

The claimant sought entitlement to non-earner and medical benefits. The insurer asserted a MIG defence. Adjudicator Truong considered the claimant's testimony regarding her pre- and post-MVA life, which included an international flight to Norway and Sweden for approximately 2 weeks. Adjudicator Truong also reviewed surveillance footage and concluded that the claimant did not suffer a...

May 18, 2017

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Applicant v. Allstate Insurance Company (16-002285)

The claimant was catastrophically impaired. An assessment of attendant care needs yielded a monthly rate beyond the statutory maximum. The insurer agreed to pay up to the statutory maximum; however, invoices showed services incurred for less and therefore only the amounts on submitted invoices were paid. The claimant argued that once an economic loss was...

May 17, 2017

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G.K. v. Security National Insurance Company (16-001904)

This preliminary matter considered whether the claimant was a resident of Ontario at the time of the accident. He had been involved in an accident in Alberta and had applied for Alberta benefits. After exhausting entitlement to Alberta benefits, he applied for Ontario accident benefits. Adjudicator Marzinotto concluded that the claimant was a resident of...

May 16, 2017

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M.B. v. Aviva Insurance Canada (16-002325)

The claimant sought entitlement to post-104 week income replacement benefits. The insurer scheduled insurance examinations, but the claimant did not attend since she returned to school full-time. The insurer raised a preliminary issue asserting the claimant was not entitled to bring a claim to the LAT due to failing to attend an IE, per section...

May 15, 2017

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S.S. v. Travellers Insurance Company (16-003555)

The insurer sought costs after the claimant failed to participate in the Case Conference on three occasions. Adjudicator Johal rejected the insurer's arguments, and noted that the changes to the Insurance Act limited the LAT's jurisdiction to award costs in comparison to a FSCO arbitrator's jurisdiction. The adjudicator also wrote that the non-attendance by an...

May 15, 2017

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S.R. v. Aviva Insurance Company of Canada (16-000954)

The claimant withdrew his claim for accident benefits at the Case Conference following revelations that he had not disclosed previous medical issues to IE assessors or during an examination under oath. The insurer sought its costs. Adjudicator Shapiro denied the insurer's requests for costs, given the claimant's limited English skills and cognitive difficulties.

May 15, 2017

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S.B. v. Aviva General Insurance (16-004395)

The claimant sought entitlement to medical and income replacement benefits. The insurer asserted a MIG position. Adjudicator Derek concluded the claimant had not proven he had injuries to warrant removal from the MIG, nor had a pre-existing condition impeding recovery within the MIG. Regarding IRBs, the claimant only relied on his disability certificate. The insurer's...

May 15, 2017

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M.O. v. Unifund Assurance Company (17-000043)

The claimant sought entitlement to medical benefits and then she withdrew at a case conference, after the insurer objected to her non-attendance at an IE. The claimant then brought another LAT application for medical benefits. The insurer reiterated its objection that the claimant failed to attend a rescheduled IE, and she again withdrew at the...

May 15, 2017

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G.D. v. The Personal Insurance Company (16-003190)

The claimant sought removal from the MIG and entitlement to five treatment plans. Adjudicator Hines found that the claimant did not submit sufficient evidence to support that he suffered a non-minor injury. She also held that the claimant did not adduce evidence explaining why Type 2 Diabetes or Hepatitis B would prevent the claimant from...

May 12, 2017

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Applicant v. TD General Insurance Company (16-000608)

The claimant was involved in two motor vehicle accidents, and sought IRBs in relation to both accidents. Adjudicator Leslie held that the claimant had not provided evidence regarding the impairments preventing him from performing his work functions beyond the date the insurer had paid IRBs. Further, the claimant himself reported that he was not prevented...

May 8, 2017

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G.S. v. Aviva Insurance Company of Canada (16-001756)

In this case, the claimant sought entitlement to ACBs and medical benefits. The first Form 1 was submitted by the claimant after the 104 week mark. The insurer argued that it was not liable for payment of any ACBs prior to receipt of the Form 1. Vice Chair Flude accepted the insurer's arguments and held...

May 5, 2017

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Y.Y. v. Aviva Insurance (16-001997)

The claimant sought removal from the MIG and two medical benefits. Adjudicator Mather concluded that the claimant had not submitted sufficient evidence of a non-minor injury, or sufficient evidence of a pre-existing condition. The claims were dismissed.

May 5, 2017

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N.T. v. Unica Insurance Inc. (16-000920)

The insurer requested a preliminary issue to address whether the claim for attendant care benefits was barred by the limitation period. The claimant argued that his Form 1 did not qualify as an application for attendant care benefits, and that the insurer therefore could not have denied attendant care benefits. Adjudicator John held that the...

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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