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.

October 18, 2017

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Applicant v. Motor Vehicle Accident Claims Fund (17-000665)

The claimant sought removal from the MIG and entitlement to various medical benefits for physical therapy and psychological therapy. Adjudicator Markovits held that the claimant was suffering from an adjustment disorder with mixed anxiety and depressed mood, and that his injuries were therefore non-minor. In terms of the medical benefits sought, Adjudicator Markovits awarded all...

October 18, 2017

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Applicant v. Aviva Insurance (17-002240)

The claimant sought entitlement to non-earner and medical benefits. The insurer denied the benefits and asserted a MIG position. On review of the medical evidence, Adjudicator Avvy Go held the claimant suffered a minor injury with no pre-existing injury and was therefore governed by the MIG. Moreover, the medical evidence did not support the claimant...

October 16, 2017

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C.N. v. Aviva Canada Insurance (16-002658)

The claimant failed to attend two case conferences. Accordingly, the insurer sought to have the matter dismissed. The claimant argued that the matter was merely withdrawn and therefore it was available to return to the LAT to raise the same issues. The case conference adjudicator agreed with the claimant and found the issues withdrawn. The...

October 13, 2017

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B.M. v. Aviva Insurance Canada (17-000907)

The claimant was riding on a motorcycle at a privately owned and operated, training and racing facility. The motorcycle owner's manual indicated that the vehicle was designed for closed course competitions only. The motorcycle was not registered with an insurance policy nor was it plated with the Ministry of Ontario. On the day of the...

October 13, 2017

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Applicant v. Certas Direct Insurance (16-004092)

The insurer argued that the claimant had failed to attend a requested IE, and therefore could not pursue his claim for two medical benefits. Adjudicator Go held that the insurer's IE request letter did not satisfy the requirements of section 44 in failing to provide medical reasons for the examination. The claimant was therefore permitted...

October 13, 2017

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Applicant v. Aviva Insurance Company of Canada (16-001934)

The claimant sought entitlement to a chronic pain assessment. The insurer denied the assessment. Adjudicator Chris Sewrattan referenced a previous decision in the same matter where it was held that it was reasonably possible the claimant suffered from chronic pain syndrome. Based on the medical evidence, Adjudicator Sewrattan reasoned that a chronic pain assessment was...

October 13, 2017

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Applicant v. Aviva Insurance Company of Canada (16-001934)

The claimant sought entitlement to a chronic pain assessment. The insurer denied the assessment. Adjudicator Chris Sewrattan referenced a previous decision in the same matter where it was held that it was reasonably possible the claimant suffered from chronic pain syndrome. Based on the medical evidence, Adjudicator Sewrattan reasoned that a chronic pain assessment was...

October 12, 2017

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The Applicant v. Aviva General Insurance (17-004239)

The claimant sought entitlement to one treatment plan for chiropractic treatment. Adjudicator Treksler concluded that although the claimant had been diagnosed with whiplash as a direct result of the accident, she had not provided any objective medical opinion to support that the chiropractic treatment would improve or resolve her injuries. The claimant was not entitled...

October 11, 2017

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Applicant v. Allstate Insurance Company (16-003204)

The claimant sought entitlement to a number of medical treatment plans. The insurer denied the plans based on IE reports. Adjudicator Brian Norris reviewed the medical evidence and determined that the treatment plans were not reasonable and necessary. The application was dismissed.

October 10, 2017

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Melo v. Northbridge Personal Insurance Corporation (2017 ONSC 5885)

The claimant appealed Adjudicator Sewrattan's denial of further IRBs to the Divisional Court. The Court upheld the decision, writing that the standard of review was reasonableness, and that Adjudicator Sewrattan had used the proper test to consider entitlement to IRBs, applied the proper standard of proof, and grounded his reasons in the evidence before him.

October 10, 2017

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K.D. v. TD Insurance Meloche Monnex (17-004213)

The claimant brought a motion seeking to add additional issues in dispute. The insurer resisted the motion. Adjudicator Cezary Paluch relied on Rule 20.5 and noted that "the Tribunal has an obligation to ensure a fair, just, expeditious and cost efficient determination of every case on its merits." The issues were added.

October 6, 2017

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N.N. v. Allstate Insurance Company (17-000006)

The claimant sought entitlement to IRBs and three medical benefits. Adjudicator Hans concluded that as a result of the claimant's physical impairments, he was substantially unable to perform the essential tasks of his employment as a marble shop worker. The Adjudicator was not persuaded by the respondent's argument that the claimant was able to work...

October 6, 2017

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N.Y. v. TD Insurance Meloche Monnex (17-001054)

The claimant sought entitlement to accident benefits. The LAT case conference adjudicator ordered a hybrid hearing with evidence to be entered via writing. After the claimant filed submissions, the insurer responded with submissions containing addendum IE reports as evidence. The claimant made a motion objecting to the admissibility of the new addendum reports and was...

October 6, 2017

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N.Y. v. TD Insurance Meloche Monnex (17-001054)

The claimant sought entitlement to accident benefits. The LAT case conference adjudicator ordered a hybrid hearing with evidence to be entered via writing. After the claimant filed submissions, the insurer responded with submissions containing addendum IE reports as evidence. The claimant made a motion objecting to the admissibility of the new addendum reports and was...

October 4, 2017

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O.A. v. TD General Insurance Company (16-003897)

The claimant sought entitlement to income replacement benefits. The insurer denied the benefit based on the claimant being outside of the limitation period. The insurer also asserted that a completed disability certificate was not submitted within two years of the MVA, pursuant to section 36 and sought to have the application dismissed. On review of...

October 4, 2017

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L.M. v. Gore Mutual Insurance Company (16-003772)

The claimant sought entitlement to non-earner benefits. The insurer resisted the claim and relied on medical reports as well as a statement from the claimant. Adjudicator Deborah Neilson reviewed the medical evidence and distilled the claimant's pre- and post-accident activities of daily living. On review, it was held the claimant was completely disabled from performing...

October 2, 2017

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The Applicant v. Wawanesa Mutual Insurance Company (16-002823)

The claimant submitted four treatment and assessment plans to the insurer. The insurer held that the claimant had suffered minor injuries and that his treatment fell within the Minor Injury Guideline. Adjudicator Anwar explained in order to allege that an injured person has pre-existing medical injuries that required treatment in excess of the MIG limits,...

September 29, 2017

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Applicant v. The Co-operators General Insurance Company (16-003478)

The claimant and the insurer disagreed on the amount payable to a case manager. The claimant sought $150 per hour; the insurer argued that the Professional Services Guideline capped the hourly rate at $89.07. Adjudicator Maedel concluded that the PSGs applied to the services provided to the claimant, and that $89.07 was the maximum payable....

September 28, 2017

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J.M. & N.M. v. RBC General Insurance Company (17-001227 & 17-001283)

The claimants, two adult children whose mother was seriously injured in a motor vehicle accident, sought entitlement to one treatment plan each for social work assessments. The claimants failed to attend IEs. The claimants took the position that they were not required to attend the IEs because the treatment plans were automatically payable on the...

September 28, 2017

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R.D. v. Wawanesa Mutual Insurance Company (16-001535)

The deceased claimant had been involved in a motor vehicle accident in which his car rolled over and the airbags deployed. He did not seek medical attention at the scene, and met his brother-in-law at an auto repair shop. Shortly after arriving at the auto repair shop, the claimant was found unresponsive. He was taken...

September 27, 2017

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K.B. v. Intact Insurance Company (16-004096)

The claimant sought accident benefits; however, the insurer denied access and asserted that no accident within the definition had occurred. Adjudicator Rebecca Hines noted that the claimant dropped her kids off at a birthday party event at a mall. While returning to her vehicle she tripped on a pothole in the parking lot, "a few...

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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