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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February 6, 2017

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H.C. v. Certas Direct Insurance Company (16-001285)

The claimant sought entitlement to income replacement benefits along with two treatment plans, costs, and a special award. Adjudicator Bass reviewed the medical evidence, along with surveillance submitted by the insurer. It was found that the claimant's reports were "overly pessimistic in light of the surveillance evidence from only a few months later." As a...

February 3, 2017

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K.T. v. Allstate Insurance Company of Canada (16-000151)

The claimant was a pedestrian knockdown in Ontario. She applied for and received accident benefits, including IRBs, under Quebec's Quebec Societe de l'assurance automobile. Her IRBs were terminated 11 months post-accident and she did not appeal the decision. She then applied for IRBs in Ontario. The insurer paid IRBs and terminated benefits up to and...

February 3, 2017

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Applicant v. TD Home and Auto Insurance Company (16-000929)

The claimant sought entitlement to income replacement benefits. Adjudicator Sewrattan stated that a claim must be broken into three steps: (i) was the claimant employed at the date of loss, (ii) causation [do the injuries suffered prevent working within the first 104 weeks], and (iii) does the claimant suffer a substantial inability to perform the...

February 2, 2017

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J.S. v. RBC Insurance Company (16-000576)

The claimant sought entitlement to eight treatment plans. The insurer maintained a MIG position. Adjudicator Makhamra found the claimant failed to meet the burden of proof to warrant removal from the MIG. The claimant holds the onus to prove removal from the MIG is justified. In doing so, Adjudicator Makhamra distilled the analysis to three...

February 1, 2017

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Applicant v. Aviva (16-001144)

The claimant sought entitlement to income replacement benefits and an orthopaedic assessment. The insurer paid IRBs for four months and terminated them after a number of IE reports. The orthopaedic assessment was denied based on a MIG position. As a preliminary issue, the insurer sought to add the claimant's LinkedIn page to show the claimant...

January 31, 2017

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J.V. v. Wawanesa Mutual Insurance Company (16-000722)

The claimant sought an order for IRBs in the amount of $280 per week. Adjudicator An concluded that the claimant suffered a substantial inability to engage in the essential tasks of her employment up to the date of her return to work.

January 31, 2017

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J.M. v. Wawanesa Mutual Insurance Company (16-000258)

This decision addressed procedural issues in the awarding of a neurocognitive assessment. Adjudicator Sewrattan wrote that an assessment requested by the claimant was reasonable for the purpose of determining causation in relation to a catastrophic impairment claim. In terms of LAT process, the adjudicator held that both the parties had exceeded the 10 page limit...

January 30, 2017

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S.C.W.H. v. The Dominion of Canada General Insurance Company (16-000677)

The claimant sought entitlement to two chiropractic treatment plans and removal from the MIG. Adjudicator Makhamra concluded the claimant's injuries fell within the MIG and therefore the treatment plans were not payable. The claimant did not submit medical evidence in support of the non-MIG injuries. It was noted that the pre-existing medical condition to warrant...

January 30, 2017

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M.M.S. v. Wawanesa Mutual Insurance Company (16-000435)

The claimant sought costs in the amount of $1,000 for the insurer's failure to produce documents in accordance with the Case Conference Order. Adjudicator Lester awarded costs of $250, reasoning that the insurer had been disrespectful of the Tribunal's process.

January 30, 2017

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F.V. v. Wawanesa Mutual Insurance Company (16-001811)

The claimant had sustained a catastrophic impairment and sought entitlement to rehabilitation benefits funding a trip to Florida and Disney World. Adjudicator Lester held that the proposed treatment did not fall within the scope of activities set out in section 16 of the SABS, and dismissed the claim.

January 30, 2017

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B.F. v. Wawanesa Mutual Insurance Company (16-000433)

The claimant sought costs in the amount of $1,000 for the insurer's failure to produce documents in accordance with the Case Conference Order. Adjudicator Lester awarded costs of $250, reasoning that the insurer had been disrespectful of the Tribunal's process.

January 27, 2017

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P.B. v. RBC Insurance Company (16-000284)

The claimant submitted an accounting report in respect of an IRB quantum. The insurer paid $2,500.00 per section 7(5) of the SABS. The claimant sought a further amount for HST. Adjudicator Sewrattan dismissed the claim for outstanding HST. The adjudicator also dismissed the claim for costs made by the insurer, stating that cost awards are...

January 27, 2017

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M.P. v. Certas Home and Auto Insurance Company (16-000525)

As a result of the accident, the claimant suffered severe knee injuries. The claimant's wife was a personal attendant at Seniors for Seniors. She provided attendant care service to the claimant, and the claimant sought entitlement to ACBs. Adjudicator Sewrattan held that the claimant was not entitled to ACBs because the service provider was not...

January 24, 2017

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M.N.K.A. v. State Farm Mutual Automobile Insurance (16-001592)

The claimant sought entitlement to NEBs and two medical benefits. Adjudicator Bass denied all claims as not meeting the requisite test for entitlement.

January 24, 2017

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Applicant v. Unifund Assurance Company (16-000879)

The claimant sought an order for NEBs, and medical benefits. As a preliminary issue, the insurer sought the exclusion of documents not produced in accordance with the Case Conference Order. Adjudicator Truong held that the Tribunal could set deadlines that were more stringent than those in the LAT Rules. The documents were excluded and the...

January 20, 2017

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C.S.Z. v. Allstate Insurance Company of Canada (16-000270)

The claimant sought IRBs in the amount of $400 per week. Adjudicator Marzinotto allowed the admission of surveillance evidence. She also allowed the admission of a report without an Acknowledgement of Expert's Duty. In terms of the benefits in dispute, the adjudicator denied the claim for IRBs, stating that the claimant had not proved his...

January 19, 2017

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M.B. v. Dominion of Canada General Insurance (16-001825)

The claimant's application was dismissed due to his failure to participate in the Case Conference.

January 17, 2017

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V.S. v. The Dominion of Canada General Insurance Company (17-001670)

The claimant sought entitlement to a number of medical treatment plans. The insurer asserted the claimant was governed by the MIG. The claimant raised an objection to the insurer's notice letters. However, Adjudicator S.F. Mather determined the correspondence was compliant and that a medical reason was provided. On review of the medical evidence, Adjudicator Mather...

January 17, 2017

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R.H. v. TD Insurance Meloche Monnex

The claimant sought entitlement to medical benefits and removal from the MIG. Adjudicator Leslie concluded that the insurer had not complied with section 38 of the SABS in the denial timeline, and that the insurer was therefore prohibited from taking the position that the MIG applied. One of the claimed treatment plans was awarded.

January 12, 2017

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E.S. v. Unifund Assurance Company (16-000691)

The claimant sought entitlement to further medical benefits. Adjudicator Bass concluded that no further passive therapy was reasonable and necessary, and that the claimant did not require further psychological treatment.

January 12, 2017

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Applicant v. Co-operators General Insurance Company (16-000714)

The claimant sought NEBs, medical benefits, and removal from the MIG. The adjudicator found that the claimant did not satisfy the burden of being removed from the MIG. There was a causation issue as the claimant was involved in two separate accidents and the alleged injuries from each accident were similar. NEBs were denied on...

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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