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.

Search

Generic filters

March 1, 2022

/

tgp-admin

Aflo v. Aviva General Insurance Company (20-001404)

The claimant applied to the LAT because its insurer sought to deduct EI sickness benefits from her IRBs as "gross employment income". Vice Chair Johal found that EI sickness benefits were not deductible from an IRB. Vice Chair Johal rejected the insurer's argument that the EI sickness benefits were being received as a result of...

February 28, 2022

/

tgp-admin

Tagoe v. The Personal Insurance Company (21-001366)

A preliminary issue hearing was held to determine whether the claimant was barred from proceeding with his claim for IRBs due to failure to commence his application within two years after the insurer's refusal to pay the amount claimed. Adjudicator Corapi concluded that the claimant was statute-barred from proceeding with his application for IRBs and...

February 28, 2022

/

tgp-admin

Bablak v. Gore Mutual Insurance Company (20-002022)

The matter had previously been set down for a five-day hearing to commence on June 7, 2021. On June 7, 2021, counsel for the claimant authored an email to the LAT and the insurer's counsel stating that the claimant was withdrawing the LAT Application. The claimant did not submit a formal Notice of Withdrawal. The...

February 24, 2022

/

tgp-admin

Zhang v. The Co-Operators General Insurance Company (20-003427)

The claimant disputed entitlement to the unapproved balance of $5,912.81 for CAT assessments. The unapproved portion of the assessments represented four file review assessments and transportation costs (before the first 50 km). Adjudicator Norris held that any fee associated with reviewing files should be included in the $2,000 assessment fee. He further held that as...

February 23, 2022

/

tgp-admin

Huang v. The Dominion of Canada General Insurance Company (19-006264)

The self-employed claimant sought entitlement to IRBs in the amount of $400.00 per week. The sole issue in dispute related to calculating the claimant's quantum of IRB, as the insurer calculated the claimant's IRB quantum at $0 per week. Adjudicator Kepman agreed with the insurer, and held that personal income tax returns and payroll summaries...

February 23, 2022

/

tgp-admin

Fehr v. Intact Ins. Co. (21-003866)

The claimant was involved in an incident where he fell off the roof of a transport truck and sustained a traumatic brain injury. The claimant placed a ladder against the side of the transport truck to inspect its roof. While conducting his inspection, the ladder slid out from under him. The claimant attempted to grab...

February 23, 2022

/

tgp-admin

Alazab v. Aviva General Insurance (19-011494)

A preliminary issue hearing was held where Adjudicator Norris determined that the claimant was barred from proceeding under the doctrine of res judicata. The Tribunal had previously determined that the claimant's injuries had not been caused or exacerbated by the accident. The claimant argued that her second application was for now for entitlement to NEBs...

February 22, 2022

/

tgp-admin

Maycid v. TD General Insurance Company (20-012985)

The claimant was involved in an accident in Quebec. He submitted his OCF-1 to the insurer, and elected under section 59 to receive SAAQ benefits. A disagreement arose between the claimant and the insurer as to the SAAQ benefits the claimant was entitled to. The claimant applied to the LAT. The insurer argued that the...

February 17, 2022

/

tgp-admin

Kunaseelan v. Aviva Insurance Company of Canada (20-000565)

The claimant sought entitlement to IRBs of $400.00 per week for the five month period between the date of loss and the date the OCF-3 was submitted. Adjudicator Norris dismissed the claim, holding that section 36(3) barred the claimant's entitlement to IRBs for the period prior to OCF-3 submission. The claimant argued that the insurer...

February 17, 2022

/

tgp-admin

Harvey v. Economical Insurance Company (19-006159)

The claimant applied to the LAT seeking entitlement to various medical and rehabilitation benefits and a special award. In addition, the claimant brought a motion seeking to exclude the insurer’s submission of surveillance and the transcript from the claimant’s EUO. The claimant submitted that the insurer conducted surveillance prior to the EUO, which demonstrated that...

February 17, 2022

/

tgp-admin

Amorim v. Jevco Insurance (19-012408)

The claimant applied to the LAT seeking entitlement to attendant care benefits in the amount of $7,522.85 per month. The claimant was involved in a serious motor vehicle accident in 2012. In 2017, the insurer determined that the claimant was catastrophically impaired as a result of psychological impairments. The disputed attendant care services included feeding,...

February 15, 2022

/

tgp-admin

S.V. v. Wawanesa Insurance (18-009702 and 20-001009)

The claimant applied to the LAT for a catastrophic impairment determination due to psychological impairment, IRBs, ACBs, and various medical benefits. Adjudicator Hines concluded that the claimant did not suffer a catastrophic impairment as a result of the accident. While the claimant did sustain a psychological impairment in the accident, he sustained only Class 2...

February 15, 2022

/

tgp-admin

Samra v. Zenith Insurance Company (20-003287)

The claimant applied to the LAT disputing numerous treatment plans for therapy, assessments, and psychological treatments. The insurer raised a preliminary issue and argued that the claimant was barred from proceeding with the dispute under section 55 for failure to attend IEs to address IRBs. Vice-Chair McGee noted that the claimant had not in fact...

February 11, 2022

/

tgp-admin

DeGroot v. Licence Appeal Tribunal (2022 ONSC 6160)

The claimant appealed the Tribunal's decision awarding IRBs of $161.11 per week up to October 6, 2020, and declining to award any IRBs thereafter. The claimant also appealed the dismissal of the special award claim. The Court dismissed the appeal, holding that the Tribunal's weekly IRB award was accurate in light of the claimant's accounting...

February 9, 2022

/

tgp-admin

Fard v. Economical Insurance (19-010239)

The claimant applied to the insurer for IRBs and ACBs. The insurer paid the claimant an IRB from her initial eligibility until August 22, 2019. The insurer had arranged four IEs in July of 2019, which the claimant did not attend. The insurer rescheduled all four IEs to provide the claimant another chance to attend,...

February 8, 2022

/

tgp-admin

Teutloff v. Wawanesa Mutual Insurance Company (19-010851)

The claimant applied to the LAT for a catastrophic impairment determination due to psychological impairment. Adjudicator Grieves held that the claimant suffered from Class 4 Marked Impairments in both concentration, and adaptation, and therefor met the pre-2016 catastrophic impairment definition. The claimant suffered from Adjustment Disorder with Mixed Anxiety and Depression, and Somatic Symptom Disorder...

February 8, 2022

/

tgp-admin

Aviva Insurance Company of Canda v. Saunders (20-009069)

The insurer sought repayment of IRBs due to the claimant's return to work, which he failed to report for six months. The claimant and the insurer initial agreed to a repayment plan of $200 per month, but the claimant ceased payment eventually. The insurer sent a new repayment request for the remaining overpayment. Adjudicator Boyce...

February 7, 2022

/

tgp-admin

Zakaria v. Wawanesa Mutual Insurance Company (20-008398)

The claimant sought entitlement to NEBs and various medical benefits. The insurer raised a preliminary issue regarding the admissibility of the claimant's chronic pain assessment, which was served two months after the production date set at the Case Conference. Adjudicator Kepman found the claimant's chronic pain assessment inadmissible, as the claimant consented to the production...

February 7, 2022

/

tgp-admin

Joseph v. ACE INA Insurance (19-010124)

The claimant was involved in a motor vehicle accident in 2018. He was later determined to be catastrophically impaired as a result of the accident. The claimant applied to the LAT seeking entitlement to numerous medical and rehabilitation benefits, including the cost of cancellation fees, home modifications totaling $262,619.50, the cost of a trip to...

February 7, 2022

/

tgp-admin

Keshavarz v. Aviva General Insurance (20-001377)

The claimant sought a special award from the insurer relating to the denial and subsequent approval of a psychological assessment prior to a LAT hearing. Adjudicator Hines determined that the insurer unreasonably withheld and delayed payment of a treatment plan for the psychological assessment. As a result, she determined that a special award of 25...

February 5, 2022

/

tgp-admin

Johnson v The Dominion of Canada General Insurance Company (20-001056)

The claimant was involved in a motor vehicle accident and sought benefits pursuant to the SABS. On January 24, 2019, the claimant filed a LAT application to determine whether her injuries fell within the MIG as well as her entitlement to various treatment plans. On February 4, 2020, the claimant filed a second application which...

Contact Us

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

416.507.1850

smilne@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP Disclaimer | Privacy Policy | Statement of Principles

Powered by Crow & Pitcher

Subscribe to get TGP’s case summaries straight to your inbox

Subscribe to get TGP’s case summaries straight to your inbox

Contact Us

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

416.507.1850

smilne@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP