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 15, 2017

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S.B. v. Aviva General Insurance (16-004395)

The claimant sought entitlement to medical and income replacement benefits. The insurer asserted a MIG position. Adjudicator Derek concluded the claimant had not proven he had injuries to warrant removal from the MIG, nor had a pre-existing condition impeding recovery within the MIG. Regarding IRBs, the claimant only relied on his disability certificate. The insurer's...

May 15, 2017

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M.O. v. Unifund Assurance Company (17-000043)

The claimant sought entitlement to medical benefits and then she withdrew at a case conference, after the insurer objected to her non-attendance at an IE. The claimant then brought another LAT application for medical benefits. The insurer reiterated its objection that the claimant failed to attend a rescheduled IE, and she again withdrew at the...

May 15, 2017

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G.D. v. The Personal Insurance Company (16-003190)

The claimant sought removal from the MIG and entitlement to five treatment plans. Adjudicator Hines found that the claimant did not submit sufficient evidence to support that he suffered a non-minor injury. She also held that the claimant did not adduce evidence explaining why Type 2 Diabetes or Hepatitis B would prevent the claimant from...

May 12, 2017

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Applicant v. TD General Insurance Company (16-000608)

The claimant was involved in two motor vehicle accidents, and sought IRBs in relation to both accidents. Adjudicator Leslie held that the claimant had not provided evidence regarding the impairments preventing him from performing his work functions beyond the date the insurer had paid IRBs. Further, the claimant himself reported that he was not prevented...

May 8, 2017

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G.S. v. Aviva Insurance Company of Canada (16-001756)

In this case, the claimant sought entitlement to ACBs and medical benefits. The first Form 1 was submitted by the claimant after the 104 week mark. The insurer argued that it was not liable for payment of any ACBs prior to receipt of the Form 1. Vice Chair Flude accepted the insurer's arguments and held...

May 5, 2017

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Y.Y. v. Aviva Insurance (16-001997)

The claimant sought removal from the MIG and two medical benefits. Adjudicator Mather concluded that the claimant had not submitted sufficient evidence of a non-minor injury, or sufficient evidence of a pre-existing condition. The claims were dismissed.

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...

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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