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.

August 21, 2018

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Applicant v. Aviva Insurance Canada (17-006138)

The claimant sought entitlement to two treatment plans for chiropractic and psychological services. Adjudicator Watt found that the claimant was not entitled to the benefits in dispute. Adjudicator Watt found that many of the medical complaints raised by the claimant were not connected to the 2013 motor vehicle accident. Adjudicator Watt found that the treatment...

August 21, 2018

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Applicant v. Aviva General Insurance (17-006831)

The claimant sought a determination that her impairments were outside of the MIG and entitlement to attendant care and medical benefits proposed in six treatment plans. Pursuant to s. 56 of the SABS, Adjudicator Watt found that the claimant was statute barred from seeking attendant care benefits as the benefits were denied more than two...

August 21, 2018

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Applicant v. Aviva Canada Inc. (17-005825)

The claimant sought entitlement to various medical benefits and a special award. Adjudicator Létourneau concluded that all of the proposed treatments were reasonable and necessary for the claimant's injuries. The family physician had diagnosed chronic pain and recommended ongoing physical therapy. The claimant also demonstrated psychological impairments that required ongoing treatment. The IE reports did...

August 21, 2018

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V.H. v. Certas Home & Auto Company (17-006293)

The claimant sought entitlement to mileage for the cost of her medical service providers attending her home. She argued that because she was in a rural community without such services, it was reasonable and necessary for such payments to be made. The insurer argued that it was paying for the travel time of the treatment...

August 21, 2018

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A.F. v. North Blenheim Mutual Insurance Company (16-002336)

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the...

August 21, 2018

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A.F. v. North Blenheim Mutual Insurance Company (16-002336)

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the...

August 21, 2018

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A.F. v. North Blenheim Mutual Insurance Company (16-002336)

Following a reconsideration of the initial decision, the Tribunal was asked to decide whether the limitation period should be waived in accordance with section 7 of the LAT Act. Adjudicator Watt concluded that the limitation period should not be waived. He held that the claimant had failed to heed direction from the LAT that the...

August 20, 2018

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R.H. v. Wawanesa Mutual Insurance Company (17-005570)

The insurer alleged that the accident was staged and refused to pay accident benefits. The claimant sought disclosure of the insurer's unredacted log notes, the property damage file, and the notes for the related BI claims. Adjudicator Maedel ordered that the insurer produce redacted log notes pertaining to the accident investigation and denial of benefits...

August 17, 2018

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M.R. v Aviva Insurance Canada (17-007428)

The claimant sought entitlement to various medical benefits and the costs of a chronic pain examination. The Tribunal was also asked to determine whether the claimant was statute-barred from disputing one of the denied benefits, as he failed to commence his application within the two year time frame. Adjudicator Kepman concluded that the application for...

August 17, 2018

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Applicant v RBC General Insurance Company (17-007471)

The claimant argued that his injuries fell outside the MIG due to a pre-existing condition that prevented him from achieving maximal recovery under the MIG and due to a psychological injury that was not mere sequelae of his soft tissue injuries. The claimant sought medical benefits for a psychological assessment and chiropractic services, as well...

August 15, 2018

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Applicant v. Aviva Insurance Canada (17-007527)

The claimant sought a determination that her impairments were outside of the MIG and entitlement to medical benefits proposed in three treatment plans. Adjudicator Maleki-Yasdi found that the claimant's psychological impairment took her outside of the MIG, based on evidence that pre-existing psychological issues were exacerbated by the accident. The claimant was found entitled to...

August 15, 2018

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K.D. v. Wawanesa Mutual Insurance Company (18-001020)

The claimant's mother was involved in an accident while an occupant of a friend's vehicle. The mother did not have insurance of her own. The claimant applied for accident benefits under the friend's policy. The insurer argued that the claimant was not an insured person under the policy and not entitled to accident benefits. Adjudicator...

August 14, 2018

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Applicant v Aviva Insurance Canada (17-008107)

The claimant sought entitlement to IRBs and interest on the overdue payment of benefits. Adjudicator Ferguson held that the claimant was not entitled to IRBs or interest as she did not prove that she suffered a substantial inability to perform the essential tasks of her pre-accident employment. The claimant failed to disclose the availability of...

August 13, 2018

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J.R. v. CAA Insurance (17-008693)

Following a full and final settlement of the claim, the claimant sought further payment for a treatment plan that had been in dispute as part of the initial LAT application. She had not rescinded the settlement within the two day cooling off period. Vice Chair Flude concluded that the settlement amount included the payment of...

August 13, 2018

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Applicant v. Unifund Assurance Company (17-006691)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to medical benefits proposed in five treatment plans. Adjudicator Kepman found that the claimant's injuries fell outside of the MIG and that he was entitled to payment for two treatment plans for chiropractic services as well as the cost of...

August 13, 2018

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Applicant v. Economical Mutual Insurance Company (17-004874)

The claimant was a minor at the time of the accident. The insurer denied NEBs around the six months mark. The claimant applied to the LAT to dispute NEBs more than two years after turning 18 years old. The insurer argued that the limitation period barred the claim. Adjudicator Johal agreed that the claim was...

August 10, 2018

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Applicant v. Motor Vehicle Accident Claims Fund (17-001681)

The claimant suffered a catastrophic impairment following a motorcycle accident which caused a traumatic brain injury. He sought entitlement to NEBs, ACBs, a rehab support worker, home modifications, and a special award. The Fund denied his entitlement to the claimed benefits. It also argued that the claimant did not have a valid licence and was...

August 10, 2018

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S.S. v. Economical Mutual Insurance Company (17-002867)

The claimant sought entitlement to attendant care benefits and housekeeping expenses after a catastrophic impairment application. The insurer argued that those benefits had been denied more than two years prior, and were therefore statute barred. Adjudicator Johal agreed with the insurer. He held that the denials of HK expenses and ACBs were clear and unequivocal...

August 10, 2018

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S.S. v. Economical Mutual Insurance Company (17-002867)

The claimant sought entitlement to attendant care benefits and housekeeping expenses after a catastrophic impairment application. The insurer argued that those benefits had been denied more than two years prior, and were therefore statute barred. Adjudicator Johal agreed with the insurer. He held that the denials of HK expenses and ACBs were clear and unequivocal...

August 9, 2018

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Applicant v. Liberty Insurance (17-006380)

The claimant was struck on the head by an unidentified cyclist travelling on the sidewalk while she was taking something out of her work vehicle. She sought accident benefits. The insurer argued that the facts of loss did not qualify as an accident. Adjudicator Hans concluded that the incident was an accident for the purposes...

August 7, 2018

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Applicant v. Allstate Canada (17-005189)

The claimant sought entitlement to two treatment plans for physical and psychological treatment. Adjudicator Grieves denied the claims. She held that the claimant's physical complaints were not supported by prescriptions or referrals to specialists, and no objective evidence of injury was submitted. Similarly, the adjudicator denied entitlement to the psychological treatment based on the insurer's...

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

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

416.507.1850

eodonnell@tgplawyers.com