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.

September 22, 2017

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I.S. v. Aviva Insurance Canada (17-001098)

The claimant sought entitlement to attendant care benefits. The insurer requested further information from the service provided pursuant to section 46.2. The insurer asserted that the claimant was barred from proceeding to a hearing given the failure to provide the material outlined under section 46.2. Adjudicator Avvy Go ordered the claimant to provide the requested...

September 22, 2017

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M.F.Z. v. Aviva Insurance Canada (16-000517)

The Tribunal had determined in both cases that the MIG did not apply because the insurer failed to comply with section 38(8) of the SABS. The insurer sought reconsideration. Executive Chair Lamoureux held that the Tribunal had not made a significant error in concluded that section 38(8), and that the insurer's notice was deficient. She...

September 21, 2017

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V.A. v. Co-operators General Insurance Company (17-001327)

The insurer requested a preliminary motion to determine whether the claimant was barred from seeking income replacement benefits due to the limitation period. Adjudicator Neilsen held that the limitation period did not apply because the claimant was only deemed to have received a denial from the insurer five days after it was mailed her (per...

September 20, 2017

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S.H. v. Northbridge Personal Insurance Company (16-000915)

The claimant was involved in an accident while in the course of employment driving a tractor trailer. He opted out of the WSIB regime to join a class action claim against the Government of Newfoundland for failing to ensure its highways were free of wildlife (including moose). He received accident benefits from the insurer while...

September 20, 2017

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H.S. v. Northbridge Personal Insurance Company (16-001133)

The claimant was involved in an accident while in the course of employment driving a tractor trailer. He opted out of the WSIB regime to join a class action claim against the Government of Newfoundland for failing to ensure its highways were free of wildlife (including moose). He received accident benefits from the insurer while...

September 19, 2017

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J.K.H. v. Northbridge Insurance Company (17-002468)

The claimant brought a motion seeking an adjournment of the scheduled hearing and cited the submitted of an OCF-19 as reason for the added time. Adjudicator Lori Marzinotto reviewed section 21 of the Statutory Powers Procedures Act and noted the central consideration when contemplating an adjournment is whether a full and fair hearing is possible....

September 15, 2017

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K.W. v. Unifund Assurance Company (17-001606)

The claimant sought entitlement to IRBs. The claimant provided the respondent with an OCF-10 electing a NEB. The claimant applied to the LAT regarding her entitlement to NEB, but subsequently submitted an amended application changing her claim from a NEB to an IRB. This preliminary issue hearing was brought to determine if the claimant was...

September 14, 2017

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I.T. v. The Personal Insurance Company (16-002364)

The claimant was involved in an accident while in the course of her employment as a Registered Practical Nurse. She was eligible for, applied for, and received WSIB. She subsequently elected to pursue a tort action and accident benefits. The respondent denied the claimant's accident benefit claim pursuant to section 61 of the SABs, based...

September 14, 2017

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S.S. v. Wawanesa Mutual Insurance Company (16-003931)

The claimant failed to participate in the Case Conference, and failed to make written submissions on why his claim should not be dismissed. Adjudicator Maedel dismissed the claim after being satisfied that the claimant had been notified of the insurer's motion and had failed to adhere to the Case Conference order.

September 14, 2017

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P.I. v. Aviva General Insurance (17-000465)

The insurer brought two preliminary issues in defence of this accident benefits claim: first, whether the claimant was barred from pursing a LAT dispute due to failure to attend IEs, and second, whether the claimant had failed to comply with section 33 requests. Adjudicator Treksler held that the claimant was barred from pursuing income replacement...

September 14, 2017

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M.R. v. Aviva Canada (16-001739)

The claimant sought non-earner benefits. Adjudicator Hines concluded that the claimant failed to prove that she suffered a complete inability as a result of the accident. She noted that the claimant had been involved in three earlier accidents in the past few years and had made claims for NEBs in those cases. Adjudicator Hines also...

September 14, 2017

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I.S. v. Aviva Insurance Canada (17-000942)

This preliminary hearing addressed whether the claimant was involved in an "accident". She had fallen outside of her residence after disembarking from a vehicle which stopped to drop her off in front of her building. The fall occurred due to an uneven curb about three or four steps from the vehicle. Adjudicator Daoud concluded that...

September 13, 2017

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J.W.X. v. Coachman Insurance Company (17-000914)

The claimant sought entitlement to various accident benefits. The parties reached a settlement during the hearing of the case. Adjudicator Bickley therefore closed the claim.

September 11, 2017

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C.F. v. Aviva Insurance Canada (16-002373)

The claimant sought entitlement to a number of treatment plans. The insurer asserted a MIG position and noted one treatment plan to be limitations barred. Adjudicator Avvy Go noted the burden rested with the claimant and that the evidence tendered did not tie any specific impairment to the MVA. Moreover, the impairments were described as...

September 8, 2017

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M.H. v. Certas Direct Insurance Company (16-003657)

The claimant sought entitlement to non-earner benefits and a lone treatment plan. Adjudicator Rebecca Hines, on review of the medical evidence and surveillance, determined the claimant had not met the burden of proof to establish entitlement to non-earner benefits. The lone treatment plan was deemed payable as evidence did suggest the claimant was still dealing...

September 8, 2017

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F.P. v. Aviva Insurance Company (16-002861)

The claimant sought entitlement to further medical benefits and a special award; the insurer argued that the claimant had failed to attend IEs and that the benefits were not reasonable and necessary. Adjudicator Treksler concluded that the insurer's request for IEs was not reasonable given that only one year had passed since the last IEs...

September 7, 2017

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A.G. v. Certas Home and Auto Insurance Company (17-001475)

The claimant was involved in two separate motor vehicle accidents. He sought a determination that he was entitled to IRBs under the 1996 SABS for the first accident, and under the 2010 SABS for the second accident. The respondent argued that the claimant was prevented from making the LAT applications due to expiry of the...

September 7, 2017

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S.T. v. Economical Mutual Insurance Company (16-003034)

The claimant sought entitlement to attendant care and housekeeping benefits. The insurer asserted a limitations position. The claimant's last Form 1 was submitted just prior to the 104 week anniversary of the MVA. The insurer informed the claimant that a CAT determination would be needed in order for payment beyond the 104 week period. Nearly...

September 7, 2017

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M.K. v. Aviva Insurance Canada (16-003909)

The claimant sought entitlement to attendant care benefits. The insurer resisted the application for arbitration and asserted that the determination was already decided in a previous FSCO decision. Adjudicator S.F. Mather determined that the claimant's claim before the LAT was not the same by virtue of the dates claimed. Additionally, Adjudicator Mather ruled that the...

September 7, 2017

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J.U. v. Co-operators General Insurance Company (17-000713)

Both the insurer and claimant agreed the claimant was entitled to income replacement benefits; at issue was quantum. The claimant did not provide alternative calculations, instead asserted consumer protection to avoid financial hardship. Adjudicator Therese Reilly applied the formula provided in section 4(2) and determined the insurer's calculations were correct.

September 5, 2017

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F.R. v. Unifund Assurance Company (16-004030)

The claimant brought an application for a catastrophic determination. Prior to the hearing the insurer accepted the claimant as CAT and the hearing was cancelled. The claimant then brought a subsequent application before the LAT seeking costs from the previous LAT matter. Vice Chair Terry Hunter concluded the LAT did not have jurisdiction to entertain...

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Contact Us

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

416.507.1850

eodonnell@tgplawyers.com

© 2020 Thomas Gold Pettingill LLP