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.

June 27, 2018

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Applicant v Aviva Insurance Canada (16-005271)

The Tribunal was asked to determine whether, after the claimant withdrew an application prior to a hearing, the respondent was entitled to costs, and whether the Tribunal had the jurisdiction to hear a motion for costs. Adjudicator Norris determined that the Tribunal did have the jurisdiction to hear the respondent's request for costs, as the...

June 27, 2018

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B.H. v. Certas Home and Auto Insurance Company (17-006692)

The claimant sought entitlement to the cost of an accounting report and interest on IRBs. The insurer had paid IRBs at a lower rate and then increased the weekly IRB payment upon receipt of further information. Adjudicator Ferguson held that the insurer was not required to pay for the accounting report because the claimant was...

June 25, 2018

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U.S. v. Certas Home and Auto Insurance Company (17-007003)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to benefits proposed in five treatment plans. Adjudicator Lake found that the claimant's injuries fell within the MIG and that the treatment plans in dispute were not payable as the MIG limits had been exhausted.

June 25, 2018

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Applicant v. TTC Insurance Company Limited (17-004391)

The claimant sought entitlement to various medical benefits for physical therapy, a psychological assessment, and psychological therapy. Adjudicator Ferguson denied the claims for physical therapy because the claimant had not demonstrated that her pain complaints were related to the accident. He awarded the $200 form fee related to the psychological assessment, and awarded the remainder...

June 21, 2018

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F.A. v. Aviva Insurance Canada (17-005508)

The claimant sought a determination that his impairments were outside of the MIG as well as entitlement to medical benefits proposed in three treatment plans. The claimant argued that he should be removed from the MIG due to chronic pain and pre-existing injuries from a previous motor vehicle accident. Adjudicator Maleki-Yazdi held that for chronic...

June 21, 2018

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D.V. v. Unifund Assurance Company (17-006637)

The claimant sought a determination that his impairments were outside of the MIG as well as entitlement to medical benefits proposed in one treatment plan. The claimant argued that he should be removed from the MIG due to chronic pain. The parties agreed that chronic pain as a result of the accident may remove a...

June 20, 2018

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M.R.A. v. Intact Insurance Company (17-006106)

The insurer approved the disputed treatment plans before the hearing date. The claimant sought payment of interest. Adjudicator Sewrattan concluded that interest was payable because the payment for treatment was overdue.

June 20, 2018

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Applicant v. Aviva Insurance Canada (17-006124)

The claimant sought removal from the MIG and entitlement to various treatment plans, attendant care benefits, and non-earner benefits. Adjudicator Ferguson held that the claimant's injuries fell within the MIG and that she was not entitled to NEBs. The claimant failed to demonstrate why alleged pre-existing conditions or lingering pain should remove her from the...

June 18, 2018

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G.T. v. Allstate Insurance Company (17-005131)

The claimant sought removal from the MIG and entitlement to various treatment plans. Adjudicator Mazerolle denied the claims. He held that the claimant failed to explain why the alleged pre-existing conditions would prevent recovery under the MIG, and that she failed to explain why the claimant's pain was not sequelae of a minor injury.

June 18, 2018

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The Applicant v. Aviva Insurance Canada (17-006182)

The claimant sought a determination that her impairments were outside of the MIG as well as entitlement to medical benefits proposed in six treatment plans. The claimant argued that she should be removed from the MIG due to accident-related psychological impairments and chronic pain. Adjudicator Maleki-Yazdi held that for chronic pain to fall outside of...

June 18, 2018

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The Applicant v. Aviva Insurance Canada (17-006136)

The claimant sought a determination that his impairments were outside of the MIG as well as entitlement to medical benefits proposed in ten treatment plans. The claimant argued that he should be removed from the MIG due to chronic pain. When assessing the claim of chronic pain, Adjudicator Ferguson applied the following criteria: i) Does...

June 18, 2018

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Applicant v. Aviva General Insurance (17-005091)

The insurer denied a treatment plan for chiropractic treatment and the cost of an examination based on its finding that the claimant's injuries fell within the MIG. The claimant disputed the insurer's denials. Adjudicator Driesel found that the claimant's injuries fell within the MIG. Specifically, Adjudicator Driesel rejected the claimant's assertion that pre-existing conditions precluded...

June 14, 2018

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Applicant v. Aviva Insurance Company of Canada (17-004147)

The claimant sought removal from the MIG and entitlement to IRBs and various medical benefits. The insurer argued that the claimant failed to attend an IE, which barred payment of further IRBs. Adjudicator Norris concluded that the claimant did not suffer pre-existing conditions that would prevent recovery under the MIG and that the claimant did...

June 13, 2018

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M.R. v Aviva Insurance Canada (17-005284)

The insurer denied payment for non-earner benefits. The applicant appealed and sought payment of NEBs. Adjudicator Sewrattan held that the applicant was not entitled to NEBs as she did not prove she was continuously prevented from engaging in substantially all of her pre-accident activities. The adjudicator relied on the applicant's statements to IE assessors that...

June 13, 2018

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Applicant v. Allstate Insurance Company of Canada (17-006563)

The claimant had purchased optional benefits set out at section 28(1) 5 of the SABS and sought entitlement to payment of case management services, despite not suffering a catastrophic impairment. The insurer argued that case management services were only available if the claimant suffered a catastrophic impairment. Adjudicator Parish agreed with the insurer. She held...

June 7, 2018

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D.M. v Aviva Insurance (17-003463)

The claimant sought entitlement to NEBs, attendant care, two medical benefits, interest, and costs. Adjudicator Johal found the claimant's complaints of pain to be credible, but did not find that his pain-related restrictions equated to a complete inability to carry on a normal life; as such, the claimant's entitlement to NEBs was denied. However, Adjudicator...

June 7, 2018

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I.K. v. Coseco Insurance Company (17-004897)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to medical benefits proposed in five treatment plans. The claimant argued that he should be removed from the MIG due to psychological impairments, chronic pain, and pre-existing migraines and left wrist/arm pain. Adjudicator Boyce found that pursuant to s. 55(1)2...

June 7, 2018

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Applicant v. Aviva Insurance Canada (17-007036)

The claimant sought entitlement to IRBs, occupational therapy treatment, the cost of an in-home occupational therapy assessment, and a special award. The respondent submitted that the claimant was barred from filing a LAT application due to failure to attend a s. 44 assessment, pursuant to s. 55 of the SABS. The s. 44 assessment had...

June 7, 2018

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G.V. v. Northbridge General Insurance (16-001698)

The insurer sought reconsideration of the Tribunal's decision to issue a special award on medical benefits after the insurer removed the claimant from the MIG. Associate Chair Batty allowed granted the reconsideration and cancelled the special award. He held that the insurer's approval of benefits in advance of a hearing was insufficient to warrant a...

June 6, 2018

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A.C. v. Economical Mutual Insurance Company (17-005685)

The claimant sought entitlement to NEBs. The insurer argued that the claimant failed to dispute entitlement within two years of the denial. The claimant conceded that he had not disputed entitlement within two years, but argued that his claim was not discoverable during the period. Adjudicator Go held that the principles of discoverability did not...

June 6, 2018

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Applicant v. Aviva General Insurance (17-005010)

The insurer denied the claimant's entitlement to certain attendant care benefits. The claimant disputed the insurer's denial and argued that the payments were unreasonably withheld or delayed. With respect to the period of time from when the first Form 1 was provided by the claimant to the time when the claimant started to incur attendant...

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Contact Us

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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