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.

May 1, 2018

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Applicant v. Aviva Insurance Company (17-002973)

The claimant sought entitlement to IRBs, ACBs, and medical benefits. The insurer argued that the claimant failed to attend an IE assessment contrary to the SABS. Adjudicator Maedel agreed with the insurer in regard to most of the claimed benefits, and held that the IEs were not requested inappropriately. In terms of the MIG and...

April 28, 2018

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Applicant v. Certas Direct (17-002792)

The claimant sought entitlement to IRBs, one treatment plan, and interest. Adjudicator Msosa held that the medical evidence did not indicate the claimant had suffered a substantial inability to perform his employment as a security guard and was therefore not entitled to IRBs. The claimant argued that the treatment plan was payable as the insurer...

April 26, 2018

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V.S. v. Travelers Insurance Company of Canada (17-001670)

The claimant sought reconsideration that he was not entitled to treatment outside of the MIG. With the insurer having approved both treatment plans in dispute and removing the claimant from the MIG in advance of the reconsideration hearing, the single issue to be decided was whether the claimant was entitled to interest on the insurer's...

April 25, 2018

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Applicant v. Aviva Insurance Company (17-002638)

The claimant sought entitlement to ongoing IRBs, various medical benefits outside of the MIG, and a special award. The claimant submitted that psychological impairments and chronic pain took him outside of the MIG. Adjudicator Boyce found that the claimant's impairments were predominantly minor injuries, holding that in the absence of evidence of a full or...

April 25, 2018

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Applicant v. Certas Direct Insurance Company (16-003108)

The claimant sought entitlement to NEBs, ACBs, and a chronic pain assessment. The insurer argued that the claimant was barred from seeking the chronic pain assessment for failure to attend an IE assessment. Adjudicator Anwar found that the claimant was barred from pursuing the cost of the chronic pain assessment due to her nonattendance at...

April 24, 2018

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J.G. v. Travelers Canada (17-001630)

Prior to the written hearing, the respondent agreed to remove the claimant from the MIG and pay any invoices for incurred treatment. The claimant decided to proceed with the hearing and sought entitlement to a special award, costs, and interest on overdue payments. Adjudicator Sharma held that the claimant was entitled to the claimed interest...

April 24, 2018

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Applicant v. Aviva Insurance Company (17-003600)

The claimant sought entitlement to medical benefits outside of the MIG and a special award. Adjudicator Victor found that the claimant was outside of the MIG because of the extent of her psychological symptoms, and she was entitled to the cost of a psychological assessment, plus interest. The claimant was not found entitled to a...

April 24, 2018

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P.R. v. Aviva Canada Insurance (16-002782)

The insurer requested reconsideration of the LAT's decision to deny its request for costs, arguing that the claimant's failure to address serious evidentiary issues throughout he proceeding amounted to frivolous and vexatious conduct warranting a costs award. Associate Chair Batty denied the request. While the LAT did not explicitly apply the definitions of frivolous and...

April 23, 2018

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J.B. v Allstate Canada (17-005951)

The claimant sought medical benefits for driver reintegration sessions and psychotherapy sessions, as well as travel expenses. Adjudicator Maedel held that the claimant failed to establish that the benefits sought were reasonable and necessary. Allstate had partially approved the OCF-18 in dispute for eight one-hour weekly driver reintegration sessions and six one-hour psychotherapy sessions, as...

April 23, 2018

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B.A. v Certas Direct Insurance Company (17-004796 and 17-004801)

The claimant was involved in two motor vehicle accidents and appealed Certas' MIG determination for each accident. The claimant also sought medical benefits for physiotherapy for the first accident and chiropractic services for the second accident. Adjudicator Cavdar held that the claimant's injuries for each accident fell within the MIG. The claimant suffered soft-tissue injuries...

April 23, 2018

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Applicant v. Co-Operators Insurance Company (17-006513)

The claimant sought medical benefits outside of the MIG and interest on the overdue payment of benefits. Adjudicator Ferguson held that the claimant's injuries fell within the MIG and dismissed the claimant's application. Adjudicator Ferguson relied on the claimant's self-reporting to conclude that the claimant did not have a credible psychological injury arising from the...

April 23, 2018

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Applicant v. Royal Sun Alliance Insurance (17-001746)

The minor claimant was injured in an accident when he was six years old. He sought entitlement to NEBs after his sixteenth birthday. The insurer terminated NEBs after obtaining IE reports. Adjudicator Ferguson agreed with the insurer that the claimant did not suffer a complete inability to live a normal life. The evidence showed that...

April 23, 2018

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S.L. v. Aviva Insurance Company of Canada (17-004989)

The claimant sought entitlement to three treatment plans, costs of various examinations, and interest on overdue payments. The insurer denied the first two treatment plans as the claimant had not exhausted MIG limits, but had later removed the claimant from the MIG. The insurer denied the third plan for not being reasonable and necessary, as...

April 23, 2018

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Aviva Insurance Canada v. W.T. (17-004341)

The insurer sought repayment of IE costs, the cost of disability certificate, and various investigation costs based on the claimant not being an occupant in the vehicle at the time of the accident. Adjudicator Ferguson held that the claimant was not an occupant of the vehicle based on inconsistencies in reporting, and that he made...

April 20, 2018

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Applicant v. Aviva Insurance (17-005318)

The claimant sought an adjournment of the hearing because the insurer's IE assessor was unavailable. The insurer opposed the adjournment. Adjudicator Makhamra granted the adjournment, reasoning that the claimant was entitled to cross examine the IE assessor as part of her case.

April 20, 2018

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Applicant v. Aviva Insurance Company (17-005081)

The claimant sought entitlement to three treatment plans, and interest on overdue payments. The insurer brought a preliminary issue concerning whether the applicant was precluded from submitting evidence regarding the benefits in dispute; more specifically, the claimant had failed to submit two of the treatment plans to the Tribunal. Adjudicator Go determined that, it was...

April 18, 2018

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Applicant v. CAA Insurance (17-001138)

The Tribunal was asked to determine whether the claimant was barred from proceeding with his appeal of the insurer's denial of medical benefits owing to his failure to attend scheduled examinations, in contravention of section 44. The claimant had sought a determination of catastrophic impairment. The insurer indicated that further IEs were required to make...

April 18, 2018

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Applicant v. Aviva Insurance Canada (17-003597)

The claimant sought entitlement to medical benefits outside of the MIG, costs of a psychological examination, a special award, and interest. On the basis of the evidence presented by both parties, Adjudicator Hans held that the claimant's injuries fell within the MIG. The claimant also failed to prove that an earlier motor vehicle accidents and...

April 13, 2018

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M.S. v. Unifund Assurance Company (17-003419)

A preliminary issue hearing was held to determine whether the claimant was precluded from proceeding with a claim for income replacement benefits for her failure to dispute the denial of the benefit within the two year limitation period. The claimant argued that the limitation period did not run from the date of the insurer's purported...

April 13, 2018

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Applicant v. RBC Insurance (17-005761)

The claimant sought entitlement to treatment outside of the MIG, various medical benefits, and a special award. The claimant argued that her psychological impairments took her outside of the MIG. Adjudicator Ferguson weighed the medical evidence and determined that the claimant did not suffer a psychological injury that would warrant removal from the MIG. As...

April 13, 2018

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Valerio v. Security National (2018 ONSC 2395)

The claimant sought judicial review of the LAT's decision that his injuries fell within the MIG, and that two treatment plans were not payable. The Court upheld the Tribunal's decision, concluding that it fell within the range of possible acceptable outcomes, and was therefore reasonable. The Court also held that the Tribunal's decision regarding the...

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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