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.

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...

April 10, 2018

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Applicant v. Economical Mutual Insurance Company (17-004358)

The claimant sought entitlement to NEBs, ACBs, and medical benefits. The insurer argued that the claimant failed to attend IEs; the claimant responded that the IEs were not reasonably required and several were requested after the LAT application. Adjudicator Mazerolle agreed with the insurer. He held that the IE notices provided the medical reason for...

April 10, 2018

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Applicant v. Certas Home and Auto Insurance Company (17-005145)

The claimant disputed his MIG status; entitlement to a medical benefit for physiotherapy treatment; and interest on overdue payment of benefits. Adjudicator Norris rejected that the claimant suffered a psychological injury as a result of the accident, finding that the evidence of psychological injury relied upon by the claimant was inconsistent with the entire rest...

April 6, 2018

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J.T. v RBC Insurance (17-005328)

The claimant sought entitlement to NEBs and interest. The insurer relied on the opinions of two IE assessors when concluding that the claimant did not qualify for NEBs. The claimant argued that the denial was invalid, as the assessors did not have an opportunity to review the claimant's disability certificate. Adjudicator Watt disagreed with the...

April 6, 2018

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J.B. v. Coseco Insurance Company (17-005803)

The claimant sought removal from the MIG and entitlement to medical benefits. Adjudicator Ferguson held that the claimant suffered minor injuries and was restricted to MIG level benefits. He concluded that the claimant's rheumatoid arthritis was not caused by the accident, but was instead an unrelated degenerative disease. He also rejected the position that the...

April 6, 2018

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Applicant v. Aviva General (17-005134)

The claimant disputed his MIG status and entitlement to medical benefits for payment of chiropractic treatment. Adjudicator Driesel denied all of the claims. The claimant failed to provide compelling medical evidence to establish that maximal medical recovery could not be reached within the MIG limit. He sustained sprain and strain injuries as a result of...

April 5, 2018

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M.B. v. Travelers (17-003671)

The claimant sought removal from the MIG and entitlement to psychological and physical assessments and treatment. The claimant had a pre-accident medical history relevant for depression and anxiety stemming from infertility issues. Adjudicator Hines concluded that based on the medical records and the evidence of the s. 44 and s. 25 assessors, the claimant’s pre-existing...

April 5, 2018

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F.A. v Aviva Insurance Company (17-003364)

The applicant sought various medical benefits, as well as an award pursuant to section 10 of O. Reg 664. Adjudicator Truong held that the applicant was entitled to the balance of the treatment plan for a total body assessment and documentation, but was not entitled to medical benefits for physiotherapy. The adjudicator held that the...

April 5, 2018

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Applicant v. Aviva Insurance Canada (17-003575)

The claimant sought entitlement to a neurological assessment and driving evaluation assessment. The adjudicator dismissed the claim for a neurological assessment on the basis that the claimant did not submit any evidence as to why the proposed assessment was reasonable and necessary. The adjudicator also noted that the claimant did not submit any evidence to...

April 5, 2018

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T.F. v. Peel Mutual Insurance Company (16-003316)

The claimant sought reconsideration of the Tribunal's decision that she was barred from seeking entitlement to two treatment plans, arguing that the insurer's denials did not provider the requisite medical reasons. Executive Chair Lamoureux agreed with the claimant and overturned the decision. She held that the insurer's medical reasons had to engage the specific details...

April 5, 2018

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T.F. v. Peel Mutual Insurance Company (16-003316)

The claimant sought reconsideration of the Tribunal's decision that she was barred from seeking entitlement to two treatment plans, arguing that the insurer's denials did not provider the requisite medical reasons. Executive Chair Lamoureux agreed with the claimant and overturned the decision. She held that the insurer's medical reasons had to engage the specific details...

April 4, 2018

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K.B. v. Aviva Insurance Canada (17-006903)

The claimant made a motion to add a request for a special award, seek productions, change the format of the hearing, and to add witnesses to the hearing. Vice Chair Hunter ordered a Case Conference resumption to deal with the requests, and also ordered that an in-person hearing be set.

April 4, 2018

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B.B. v. Intact Insurance (17-005966)

This was a motion to adjourn an in-person hearing, heard via teleconference. The parties resolved the issues in dispute after commencement of the motion.

April 3, 2018

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Applicant v. CUMIS General Insurance (17-002592)

The claimant sustained serious injuries and required 24 hour care. She moved homes to receive care from her father. The claimant and insurer disputed how much money the claimant was entitled to for the cost of rent (as a rehabilitation benefit). The claimant argued that she was entitled to the full cost. The insurer argued...

April 3, 2018

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Applicant v. TD Insurance (17-005449)

The insurer brought a motion arguing that the LAT could not adjudicate a catastrophic impairment dispute without some other benefits also being in dispute. Adjudicator Ferguson rejected the insurer's position and held that the LAT does have jurisdiction to determine whether a claimant is catastrophically impaired regardless of any entitlement to benefits being disputed.

March 29, 2018

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Applicant v. Certas Direct Insurance Company (17-005290)

The claimant sought removal from the MIG and entitlement to three medical benefits. Adjudicator Parish concluded that the claimant's injuries fell within the MIG. She held that the claimant did not suffer psychological injuries or chronic pain. She noted that the claimant's assessors did not adequately consider objective findings and relied upon subjective reporting without...

March 29, 2018

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N.K. v. Certas Home and Auto Insurance (17-004337 and 17-004343)

The claimant, represented by counsel, entered into a settlement agreement with respect to LAT applications for disputed entitlement to various benefits. The claimant executed a full and final release and a settlement disclosure notice, and the LAT was notified that the claimant was withdrawing his applications. The claimant subsequently informed the LAT that he wished...

March 29, 2018

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T.H. v. The Personal Insurance Company (17-000121)

The insurer sought to rely on section 38(2) of the Schedule as a defence, asserting that the claimant incurred the expense of an assessment in dispute prior to submitting the OCF-18 to the insurer for approval. The claimant brought a motion for a declaration precluding the insurer from relying on the defence for a number...

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Toronto, Ontario M5H 3S5

416.507.1850

eodonnell@tgplawyers.com

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