In the recent decision before the Licence Appeal Tribunal (LAT), K.D. v. Aviva Insurance Company, 2020 ONLAT 18-011646/AABS,Vice Chair Farlam clarified some long-held differences of opinion between insureds and insurers – or affirmed the interpretation of unambiguous statutory legislation, depending on whom you ask – regarding the calculation of a weekly base amount for income replacement benefits payable to self-employed motor vehicle accident victims.
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Lanthier-Grenier v. Intact Insurance Company
The applicant was a Quebec resident involved in a motor vehicle accident in Ontario on March 12, 2017. She was a passenger in the collision and received medical treatment in Ontario.
Guide to Automobile Accident Benefits Forms
Statutory Accident Benefits (“accident benefits”) are available to those who are injured as a result of the “use or operation of a motor vehicle”. This includes passengers, drivers, cyclists, or those who are injured by motor vehicles as pedestrians.
Applicant v. Co-operators 2020 CanLII 30387
Further clarity about limitation periods in CAT cases….
Limitation period starts to run not from the date of CAT designation, but from the date benefits claimed for, based on that designation, are denied.
17-000835 v. Aviva General Insurance Canada, 2018 CanLII 83520 (ON LAT)
After exhausting the $3,500 monetary limit available under the Minor Injury Guidelines, Aviva denied his claims for further treatment, arguing that the chronic pain that the Applicant developed does not entitle him to any additional benefits beyond the MIG limits.
Hedley v. Aviva Insurance Company of Canada, 2019 ONSC 5318
Insurers’ mere boilerplate reasons for denying treatment will no longer suffice in light of this Licence Appeal Tribunal (“LAT”) decision, which was upheld on appeal.