D.D. vs. Aviva Insurance Company, 2020 ONLAT 18-001737/AABS
Tribunal File Number: 18-001737/AABS
In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.
Between:
[D.D.]
Applicant
and
Aviva Insurance Company
Respondent
DECISION
ADJUDICATOR:
Stephanie Kepman
APPEARANCES:
For the Applicant:
[D.D.], Self-Represented
For the respondent:
Louise Kanary, Counsel
Written Hearing on:
December 5, 2018
OVERVIEW
1[D.D.] (“the applicant”) was injured in an automobile accident (“the accident”) on October 11, 2015 and sought benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 20101 (the ''Schedule''). He applied to the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) for dispute resolution when his claims for benefits were denied by the respondent.
ISSUES
2The issues to be decided are:
(i) Is the applicant entitled to a medical benefit for chiropractic services in the amount of $887.54 recommended by Integral Health in a treatment plan submitted on July 25, 2016 and denied by the respondent on August 2, 2016?
(ii) Is the applicant entitled to payments for the cost of examinations in the amount of $2,404.24 for a psychological assessment, recommended by Synoptic Medical Assessments in a treatment plan dated February 23, 2016 and denied by the respondent on February 26, 2016?
RESULT
3The applicant did not make any submissions or produce any evidence to support the application. Consequently, the applicant has not met the evidentiary burden required to prove entitlement to the benefits claimed. The appeal is dismissed.
BACKGROUND
4At the case conference on August 9, 2018, the details of the hearing were discussed and arranged with the consent of the parties. The adjudicator made an Order on August 27, 2018, which included the deadlines for the applicant’s and respondent’s submissions and evidence for the written hearing.
5A notice of written hearing was issued on November 13, 2018. The notice was delivered to counsel for the applicant and counsel for the respondent via fax and email.
6The notice reiterated the deadlines contained in the Order which advised that the applicant was to make written submissions by November 9, 2018. The respondent’s submissions were to follow by November 23, 2018, with the applicant’s reply submissions, should they be required, due by November 30, 2018.
7The applicant did not serve any submissions on the respondent or file any submissions with the Tribunal.
8On November 26, 2018, the respondent served the applicant’s counsel by email with submissions and evidence and filed the same documents with the Tribunal.
9In its written submissions, the respondent requested that the matter be dismissed, given the applicant’s failure to make his case and present any arguments or evidence in accordance with the dates set at the case conference.
10On April 29, 2019, the Tribunal’s Case Management Officer (“CMO”) contacted the applicant’s representative to obtain the status of the outstanding submissions. The applicant’s representative’s office advised that the paralegal who had been representing the applicant, Chris Rizzo, no longer worked there. The officer informed the CMO that the replacement would be sending a Declaration of Representative (“DOR”).
11That same day, the Tribunal sent a letter to both the applicant and respondent’s counsel, informing them of the applicant’s outstanding submissions and DOR were required by May 10, 2019.
12This letter was also sent by registered mailed to the applicant on May 7, 2019.
13At no time has the Tribunal been notified by the applicant of a change in contact information, despite the requirement in Rule 4.4 of the Common Rules of Practice and Procedure.
14The Tribunal never received a response from the applicant or his representative
ANALYSIS
15Considering the facts outlined above, I am satisfied the applicant has received proper notice of the written hearing pursuant to Rule 6.1. The letter sent by registered mail of May 7, 2019, was mailed to the applicant’s address, and according to the Canada Post tracking receipt, received on May 8, 2019.
16This notice was also sent to the applicant’s representative via email and fax. In addition, I am satisfied the Tribunal made additional efforts to inform the applicant of the hearing in writing and the respondent’s submissions by delivering the notice and respondent’s submissions and evidence by registered mail.
17The applicant has failed to provide any submissions or evidence for the hearing. The applicant has not responded to the respondent’s or the Tribunal’s correspondence regarding the hearing. I conclude the applicant has chosen not to proceed with the application and dismiss the application.
CONCLUSION
18Based on the submissions and evidence before me, I find the applicant is not entitled to the disputed chiropractic treatment plan and psychological assessment.
ORDER
19The application is dismissed.
Released: February 4, 2020
___________________________
Stephanie Kepman
Adjudicator