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.

February 3, 2023

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Nouracham v. Aviva General Insurance Company (21-000224)

The claimant applied to the LAT for entitlement to IRBs. Prior to the accident, the claimant, who worked as an employee on an “on call” basis, had not been called upon to work for a period of six weeks. The insurer denied IRBs on the basis that the claimant was not eligible for IRBs because...

February 3, 2023

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Gagnon v Belairdirect (20-010307)

The claimant filed a LAT Application seeking a determination of catastrophic impairment under Criteria 8. At the outset of the hearing, the claimant raised a motion to have the insurer's psychology report excluded because the psychologist had passed away and could not be cross-examined. Adjudicator Norris allowed the insurer to rely on the report but...

February 3, 2023

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Stewart v Travelers Canada (21-008891)

This is a preliminary issues decision addressing whether the claimant was barred from applying to the LAT for attendant care benefits under s. 55(3) of the SABS for failure to comply with s. 46.2(1) of the SABS (i.e., the duty of a provider to provide information). The insurer argued that there was non-compliance with s....

February 3, 2023

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Khan v. Aviva Insurance Company of Canada (21-003298)

The claimant disputed entitlement to a catastrophic impairment designation, attendant care benefits of $6,000 per month, and various medical benefits. The insurer argued that the claimant's impairments were a result of subsequent injuries and events in his life. Adjudicator Lester concluded that the accident was not the "but for" cause of the claimant's impairments, and...

February 2, 2023

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Kokulanthan v. TD General Insurance Company (20-011886)

The insurer raised a preliminary issue, arguing that the claimant's entitlement to medical benefits and IRBs was barred for non-attendance at s. 44 examinations. Adjudicator Tavlin Kaur found that the insurer's notices of examination in relation to IRBs did not comply with the SABS as they did not refer at all to the claimant's medical...

February 2, 2023

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Cabral v. Northbridge General Insurance Company (20-013500)

The claimant was involved in a motor vehicle accident on February 9, 2006 (the "2006 accident"). He brought an application seeking a CAT designation due to a mental or behavioral disorder. The insurer argued that the claimant did not suffer from a catastrophic impairment and also that his alleged injuries arose from a previous motor...

January 31, 2023

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Waterloo Insurance v. Switzer (2023 ONSC 604)

The insurer appealed the Tribunal's decision regarding the calculation of a self-employed person's IRB where the person was self-employed for less than one year. The Tribunal allowed the claimant to use income earned from his previous employer, despite not being employed at the time of the accident and not being employed in the six months...

January 31, 2023

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Simpson v. Nordic Insurance Company of Canada (21-000662)

The claimant applied to the LAT seeking entitlement to attendant care benefits, rehabilitation benefits, and a special award. The claim for ACBs was made for two distinct periods. The LAT found the claimant was not entitled to ACBs for the first period claimed as the benefits had not been incurred. The LAT did not accept...

January 30, 2023

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Zhu v. The Co-operators General Insurance Company (20-012105/AABS)

The claimant applied to the LAT to dispute entitlement to NEBs, various medical benefits, and an OCF-6 for clothing and eyewear. Adjudicator Neilson found that the claimant had not established that he suffered a complete inability to return to his pre-accident life .The claimant failed to include in his submissions evidence to support his claims...

January 30, 2023

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Rupani v. Travelers Insurance Company of Canada (21-004893/AABS0

The catastrophically-impaired claimant brought an application to dispute medical and housekeeping benefits. Her claim for housekeeping was denied because she was unable to establish that the workers that she hired had provided services in the scope of employment they ordinarily engaged in. Adjudicator Grant found that it was not enough for the claimant's hired workers...

January 27, 2023

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Adams v. Aviva Insurance Company (22-002323/AABS)

This is a preliminary decision regarding late notice to the insurer. The claimant applied for accident benefits one year after the accident. The claimant's explanation for the delay was that she had retained counsel after the accident and did not know the process for claiming benefits. The Adjudicator found that reliance on the solicitor was...

January 27, 2023

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Younes v. Liberty Mutual Insurance Company (20-006050)

This is a preliminary decision regarding late notice to the insurer. The claimant applied for Accident Benefits 20 years after the accident. In addition, the claimant’s insurance expired before the accident. Before October 1, 2003, S. 32(1) of the SABS provided that the insured must advise the insurer of an intention to claim benefits within...

January 26, 2023

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Balasubramaniam v. Aviva General Insurance Company (21-001010/AABS)

The LAT found that the claimant was not entitled to a repayment of IRBs due to non-compliance with s. 33 of the Schedule. The claim was initially heard before Arbitrator Kowalski at the Financial Services Commission of Ontario where it was ordered that the insurer pay a weekly IRB. After the arbitration, the insurer was...

January 24, 2023

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Sonnet Insurance Company v. Crooks (20-011866)

The insurer applied to the LAT, arguing that the claimant was not involved in an accident, and sought repayment of benefits. Adjudicator Grant found that the incident was staged, relying upon the claimant's own evidence at his EUO. He also found an engineering reconstruction report supported the same conclusion. The claimant's reporting of the accident...

January 24, 2023

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Schuknecht v. Economical Insurance Company (19-013098)

The insurer's request for reconsideration was granted. The issue at the hearing was the correct calculation of the quantum of IRBs. The hearing adjudicator had found the claimant was entitled to IRBs in the amount of $172.00 per week after the claimant reached age 65. The insurer argued that the LAT made errors with respect...

January 23, 2023

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Lacroix v. Intact Insurance Company (20-12380/AABS)

The claimant applied to the LAT seeking entitlement to IRBs. The insurer denied IRBs, noting that prior to the accident the claimant was working on a part-time basis and that she had managed to secure a position as a waitress after the accident. The claimant attempted to establish that her medical records showed that she...

January 22, 2023

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Sahadeo v. Pafco Insurance Company (19-006331)

This is an amended Reconsideration Decision. The claimant sought reconsideration after being found not to have a catastrophic impairment . Vice-Chair Lester found that a failure to decide on the claimant’s diagnosis was not an error of fact and law. It was not necessary to rule on the claimant's diagnosis since the level of psychiatric...

January 19, 2023

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Shaikh v. Economical Insurance Company (20-009837/AABS)

The claimant brought a LAT application to dispute NEBs and his MIG designation. Adjudicator Flude found that the claimant was not entitled to NEBs because he had failed to submit a signed application for NEBs until June 8, 2020, approximately a year after the accident of July 16, 2019. Adjudicator Flude confirmed that an application...

January 19, 2023

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Han v. Wawanesa Mutual Insurance Company (21-014475)

The claimant disputed entitlement to a physiatry assessment proposed three years after the accident but which was never incurred. Because the LAT dispute would not be determined until after the expiry of the five year policy period, the insurer brought a motion arguing that the disputed assessment could not be awarded because it was not...

January 18, 2023

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Mbarak v. Wawanesa Mutual Insurance Company (20-014858/AABS)

The claimant was involved in an accident in 2016 and applied to the LAT seeking a CAT designation. The Tribunal found that the claimant had a CAT impairment as a result of one marked impairment in Adaptation. The adjudicator noted that the claimant could not return to work, had poor memory and recall, and was...

January 18, 2023

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Prillo v. Coseco Insurance Company (20-014401/AABS-R)

The claimant filed a request for reconsideration arising from an October 14, 2022 decision, in which Adjudicator Pahuta ruled that the claimant sustained "minor injuries" and was not entitled to further treatment outside of the MIG. The claimant filed for reconsideration under Rule 18.2 (b), alleging that Adjudicator Pahuta made an error of law or...

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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