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.

September 28, 2018

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T.B. v. Aviva Insurance Canada (17-006162)

The claimant sought entitlement to various medical benefits for physical treatment and assistive devices. Adjudicator Johal concluded that the claims were not reasonable and necessary and dismissed the claims. She held that self-reports of pain were not sufficient to prove treatment was reasonable and necessary, and wrote that some form of medical documentation corroborating the...

September 27, 2018

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F.S. v. Travelers (18-000582)

The insurer argued that the claimant was barred from proceeding with the LAT dispute in accordance with section 55. Adjudicator Ferguson disagreed. He held that the claimant had notified the insurer of the accident within a few days and of his intention to claim benefits. An OCF-1 was filed within 30 days of the accident....

September 27, 2018

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Zheng v. Aviva Insurance Company of Canada (2018 ONSC 5707)

The insurer applied for judicial review of the Tribunal's decision that a denial of medical benefits that did not comply with section 38 resulted in the treatment plan being payable and barring the insurer from relying on the MIG. The court found the Tribunal's decision to be reasonable and concluded that the treatment plans were...

September 25, 2018

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Charbonneau v. Intact Insurance Company (2018 ONSC 5660)

The insurer sought judicial review of the Tribunal's decision that the claimant was involved in an accident. The claimant had been "car surfing," and was injured after falling from a moving vehicle when it made a sharp turn. The insurer argued that although the causation test was met, the purpose test was not. The Court...

September 24, 2018

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Applicant v. Travelers (17-001522)

The claimant sought removal from the MIG and entitlement to three medical benefits. Adjudicator Ferguson held that the claimant's injuries fell within the MIG. He was critical of the claimant's asserted accident-related injuries, which contradicted evidence in the WSIB file which showed pre-existing complaints of the same nature. Adjudicator Ferguson also held that the insurer's...

September 24, 2018

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Applicant v. Unifund Assurance Company (17-006328)

The claimant sought removal from the MIG and two medical benefits. Adjudicator Ferguson held that the claimant suffered from a chronic pain condition which removed him from the MIG. He relied upon the claimant's ongoing functional impairments, and the claimant's ongoing pain complaints. He also awarded the claim for further physical therapy, but denied the...

September 20, 2018

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Applicant v. Certas Direct Insurance Company (17-009179)

The claimant sought entitlement to a chronic pain treatment program. Adjudicator Ferguson found the treatment plan payable. He concluded that the claimant suffered from ongoing pain and was significantly impaired in terms of pre-accident activities. He also noted that the IE assessor found the claimant to be "approaching" maximum medical recovery, which left room for...

September 20, 2018

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Applicant v. Allstate Insurance Company of Canada (17-005138)

The claimant sought removal from the MIG and five medical benefits. Adjudicator Parish concluded that the claimant suffered minor injuries and did not suffer psychological injuries or chronic pain as a result of the accident. She did not accept the opinions of the claimant's experts. Adjudicator Parish did not permit the claimant to rely upon...

September 19, 2018

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S.S. v. Aviva Insurance Canada (17-007853)

The claimant sought entitlement to three medical benefits for physical therapy. Adjudicator Helt concluded that the proposed treatment was not reasonable and necessary. She concluded that the claimant's physical complaints pre-dated the accident, and that the evidence did not support the need for treatment in relation to the accident. The medical evidence also failed to...

September 19, 2018

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P.F. v. Jevco Insurance (18-000533)

The claimant failed to attend an examination under oath. The insurer argued that the claimant's entitlement to accident benefits was suspended. The claimant argued that the examination under oath was not properly scheduled. Adjudicator Norris held that the examination under oath was properly scheduled. He reasoned that an examination under oath can be requested after...

September 19, 2018

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Applicant v. Toronto Transit Commission (17-005228)

The claimant sought entitlement to NEBs and ACBs. Adjudicator Parish dismissed all claims. She held that the claimant was still able to perform many of the activities she engage in prior to the accident, albeit with some pain and at a reduced frequency. Adjudicator Parish also reviewed surveillance which showed the claimant engaging in normal...

September 19, 2018

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Applicant v. RBC General Insurance Company (17-003702)

The claimant sought entitlement to pre-104 week and post-104 week IRBs. Adjudicator Reilly dismissed the claims. She preferred the IE assessors opinions of that of the claimant's experts, and noted that some of the claimant's complaints did not appear causally related to the accident or pre-dated the accident. The claimant's experts also failed to consider...

September 19, 2018

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Applicant v. Toronto Transit Commission (17-005228)

The claimant sought entitlement to NEBs and ACBs. Adjudicator Parish dismissed all claims. She held that the claimant was still able to perform many of the activities she engage in prior to the accident, albeit with some pain and at a reduced frequency. Adjudicator Parish also reviewed surveillance which showed the claimant engaging in normal...

September 14, 2018

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Applicant v. Aviva Insurance Canada (17-005948)

The claimant sought removal from the MIG and entitlement to ACBs and various medical benefits. Adjudicator Sewrattan held that the claimant suffered minor injuries and dismissed the claim. He rejected that the claimant suffered from chronic pain or chronic pain syndrome because there was no medical testing in support of such diagnosis. He also rejected...

September 13, 2018

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Aviva General Insurance v. Respondent (17-007666)

The insurer sought repayment of IRBs; the claimant sought entitlement to further IRBs. Adjudicator Kershaw held that the insurer was entitled to repayment of IRBs for the period the claimant was receiving disability benefits from Co-operators Insurance (Edge). She concluded that the Edge benefits were an income continuation plan, and that it was irrelevant whether...

September 8, 2018

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Applicant v. Aviva General Insurance (17-007777)

The insurer brought a Motion seeking production of the claimant's employment and educational files from several third parties. Adjudicator Maedel found that the productions requested were relevant to the issues in dispute in the matter. He recognized that there was no explicit power under the Tribunal's Rules for third party productions and relied on sections...

September 6, 2018

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Applicant v. Aviva Insurance (18-000467)

The claimant sought entitlement to a mental health assessment. The insurer had requested the claimant's attendance at an IE to address. The claimant attended the IE but it did not proceed because the claimant wishes to record the IE. The insurer argued that section 55 barred the claimant from seeking entitlement at the LAT. Adjudicator...

September 6, 2018

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B.H. v. Aviva Canada Inc. (17-003774)

The claimant sought reconsideration of the Tribunal's decision that he could not proceed with his application due to failure to attend an IE. Executive Chair Lamoureux held that the insurer's denial of medication benefits and subsequent request for an IE did not comply with sections 38 and 44 of the SABS. She wrote that the...

September 5, 2018

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Applicant v. Aviva Insurance Canada (17-005791)

The claimant sought removal from the MIG and entitlement to four treatment plans. Adjudicator Johal concluded that the claimant's psychological injuries fell outside of the MIG, and the claimant was entitled to all four treatment plans. The insurer's assessor acknowledged that the claimant's emotional condition was significantly affecting her ability to function effectively, but did...

August 31, 2018

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Applicant v The Guarantee Company of North America (17-004229)

The claimant sought entitlement to IRBs post 104 weeks and a special award. Adjudicator Neilson held that the claimant was not entitled to IRBs after 104 weeks. The adjudicator held that the employment identified by the insurer's vocational specialist was reasonably suited by the claimant's education, training and experience; the claimant had not made a...

August 29, 2018

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Applicant v Motor Vehicle Accident Claims Fund (17-007244)

The claimant sought medical benefits for physical rehabilitation and chiropractic services, and interest on the overdue payment of benefits. Adjudicator Pinto held that the treatment plans in dispute were not reasonable and necessary and that there was insufficient objective medical evidence to support the treatment plans. Adjudicator Pinto preferred the insurer's evidence that the claimant,...

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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