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.

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May 5, 2017

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N.T. v. Unica Insurance Inc. (16-000920)

The insurer requested a preliminary issue to address whether the claim for attendant care benefits was barred by the limitation period. The claimant argued that his Form 1 did not qualify as an application for attendant care benefits, and that the insurer therefore could not have denied attendant care benefits. Adjudicator John held that the...

May 5, 2017

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Applicant v. Allstate Canada Group (16-002892)

In this preliminary motion, the insurer sought an order that the claimant was barred by the limitation period from seeking NEBs. The insurer also argued that the period for NEB entitlement did not commence until a completed disability certificate was received almost two years after the accident. Adjudicator Purdy first held that the claimant was...

May 3, 2017

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M.M. v. Wawanesa Mutual Insurance Company (16-000075)

The claimant withdrew his LAT application the morning prior to the Case Conference. The insurer sought costs. Adjudicator Johal concluded that there was insufficient evidence that the claimant had acted in a frivolous or vexatious manner or in bad faith in the LAT proceedings, and that behaviour by the claimant prior to the LAT litigation...

May 3, 2017

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C.T. v. RBC General Insurance Company (16-001142)

The claimant sought entitlement to a digital x-ray and mileage expenses. Adjudicator Treksler wrote that the claimant had not provided medical evidence in support of the need for an insurer-funded x-ray, and had failed to submit a treatment plan for the mileage expenses. Both claims were dismissed.

May 2, 2017

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F.B. v. The Dominion of Canada General Insurance Company (16-002742)

The claimant sought entitlement to attendant care, non-earner, and medical benefits. On review of the medical documentation, as well as surveillance, Adjudicator Nicole Treksler found the claimant was not entitled to medical and attendant care benefits. The applicant was seen as independent with self-care making attendant care benefits not reasonable; similar analysis was conducted for...

April 28, 2017

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Aviva Canada Inc. v. Taylor (2017 ONSC 2661)

The insurer sought a stay of LAT proceedings while it sought judicial review of two LAT orders denying the insurer's request for a hearing adjournment. Justice Kiteley denied the insurer's motion. She ruled that the insurer's request was premature, and that the LAT proceeding should reach its conclusion before the court system became involved. She...

April 26, 2017

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T.B. v. Aviva Insurance (16-001243)

The claimant withdrew her claims during the Case Conference. The insurer sought costs. Adjudicator Nemet agreed that the Tribunal could award costs at any point after the application had been filed with the LAT, but that the circumstances of the claim did not warrant costs because the claim was not unreasonable, frivolous, vexatious, or made...

April 26, 2017

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S.S. v. Aviva Insurance Company (16-002772)

The insurer argued in this preliminary motion that the claimant was barred from pursuing the claimed medical benefits due to his non-compliance with attending IEs. The claimant resisted the motion, arguing that the insurer's IE notices were insufficient. Adjudicator Truong referred to the FSCO decision in Augustin and held that the insurer's notice were compliant...

April 25, 2017

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K.B. v. Unica Insurance Inc. (16-002023)

The claimant and the insurer agreed that the claimant was medically entitled to attendant care benefits; the dispute pertained to the quantum. The claimant's entitlement was limited to the amount of economic loss sustained by his service provider mother. At the time of the accident, his mother was unemployed, but looking for work. The claimant...

April 24, 2017

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A.M. v. RBC General Insurance Company (16-000484)

The claimant initiated a proceeding at the LAT. At the case conference the claimant was ordered to provide a number of requested productions and provide written submissions. The claimant missed the deadline as ordered by the adjudicator and subsequently withdrew. The insurer sought costs. Vice Chair Terry Hunter did not award costs and reiterated the...

April 21, 2017

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Applicant v. Peel Mutual Insurance Company (16-000013)

The claimant was involved in an MVA wherein she suffered, among other things, a mild traumatic brain injury. She had not returned to work following the MVA. The claimant sought a catastrophic designation asserting she met the 55% threshold whole person impairment rating. The insurer commissioned IE reports in which it was found she had...

April 12, 2017

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J.D. v. The Dominion of Canada General Insurance Company (16-002745)

The claimant sought entitlement to attendant care, non-earner, and medical benefits. The insurer denied the benefits and had placed the claimant within the MIG. On review of the medical documentation, Adjudicator Nicole Treksler found the claimant was not entitled to any of the benefits claimed. It was noted that non-earner benefits are not automatic upon...

April 12, 2017

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D.D. v. The Dominion of Canada General Insurance Company (16-002750)

The claimant sought entitlement to medical, non-earner, and attendant care benefits. The insurer asserted a MIG position. Adjudicator Nicole Treksler was critical of the evidence tendered and noted the claimant did not specify which of the activities she was unable to perform after the MVA were important to her. Moreover, the claimant failed to provide...

April 11, 2017

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A.A. v. State Farm Mutual Automobile Insurance Company (16-000449)

A preliminary hearing was held to decide whether the claim for NEBs was barred due to the limitation period. Adjudicator Sewrattan held that the insurer's denial was clear and unequivocal, and that the claimant was therefore barred from seeking NEBs.

April 7, 2017

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M.G. v. Primmum Insurance Company (16-002951)

The claimant was a pedestrian knockdown. She claimed entitlement to two treatment plans; one psychological and the other for physiotherapy. The claimant also objected to the insurer placing her within the MIG. After reviewing the medical documentation of each party, Adjudicator Chris Sewrattan concluded the claimant suffered a psychological impairment. She was removed from the...

April 7, 2017

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J.M. v. Wawanesa Mutual Insurance Company (16-000258)

The claimant sought reconsideration of the Tribunal's decision to deny psychological treatment. Executive Chair Lamoureux rejected the reconsideration request. She held that all of the grounds raised by the claimant were essentially a re-weighing of facts of findings made by the Tribunal.

April 7, 2017

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Applicant v. TD Home and Auto Insurance Company (16-000929)

The claimant sought reconsideration of the original adjudicator's denial of further IRBs. Executive Chair Lamoureux denied the request for reconsideration and held that the adjudicator's reasons were based on the medical evidence before the Tribunal, and the adjudicator was entitled to weigh the evidence as he saw fit.

April 7, 2017

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J.M. v. Wawanesa Mutual Insurance Company (16-000258)

The claimant sought reconsideration of the Tribunal's decision to deny psychological treatment. Executive Chair Lamoureux rejected the reconsideration request. She held that all of the grounds raised by the claimant were essentially a re-weighing of facts of findings made by the Tribunal.

April 7, 2017

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Applicant v. TD Home and Auto Insurance Company (16-000929)

The claimant sought reconsideration of the original adjudicator's denial of further IRBs. Executive Chair Lamoureux denied the request for reconsideration and held that the adjudicator's reasons were based on the medical evidence before the Tribunal, and the adjudicator was entitled to weigh the evidence as he saw fit.

April 6, 2017

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J.L.H.C. v. Chubb Insurance (16-004448)

The claimant failed to attend two LAT Cases Conferences, and the insurer sought to have the matter dismissed. Adjudicator Purdy dismissed the matter as abandoned.

April 5, 2017

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M.B. v. RBC General Insurance Company (16-002963)

The claimant sought entitlement to a chronic pain program. The insurer brought a preliminary motion that the claimant had failed to attend an IE. Adjudicator Gottfried concluded that the IE notice was insufficient because it did not provide medical and other reasons for the IE, and that the claimant was not barred from seeking entitlement...

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Contact Us

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

416.507.1850

smilne@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP