Licence Appeal Tribunal
Released Date: 04/02/2020
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:
[Z. Z.]
Applicant
and
Wawanesa Mutual Insurance Company
Respondent
DECISION AND ORDER
ADJUDICATOR:
Patricia Conway
APPEARANCES:
For the Applicant:
No one appeared
For the Respondent:
Kathleen O’Hara, Counsel
HEARD: In-Person:
February 24, 2020
OVERVIEW
1The applicant was involved in an automobile accident on December 11, 2016, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (the ''Schedule''). The applicant submitted an application for dispute resolution services to the Licence Application Tribunal - Automobile Accident Benefits Service (“Tribunal”).
ISSUES
2Is the applicant entitled to receive an income replacement benefit in the amount of $400.00 per week ongoing from December 18, 2016?
3Is the applicant entitled to receive payment for a cost examination in the amount of $2,197.29 for psychological services recommended in a treatment plan submitted on April 14, 2017 and denied by the respondent on May 5, 2017?
4Is the applicant entitled to receive a medical benefit in the amount of $2,456.00 for chiropractor services recommended in a treatment plan submitted on May 16, 2017 and denied by the respondent on June 7, 2017?
5Is the applicant entitled to receive a medical benefit in the amount of $264.36 for chiropractor services recommended in a treatment plan submitted on March 22, 2017 and denied by the respondent on April 5, 2017?
6Is the applicant entitled to receive payments for expenses in the amount of $2,825.00 for an accountant’s report, submitted November 1, 2017 to the respondent?
7Are the applicant’s injuries predominantly minor as defined in the Schedule and subject to treatment within the Minor Injury Guideline?
8Is the applicant entitled to receive an award under Ontario Regulation 664 because the respondent unreasonably withheld the payment of benefits?
9Is the applicant entitled to receive interest on the overdue amounts?
HEARING
10This matter was scheduled for a 5 day in person hearing to commence on January 13, 2020. The applicant failed to appear on that day. His counsel appeared and informed the Tribunal that he no longer represented the applicant.
11The hearing adjudicator, Adjudicator Watt, after hearing submissions from the respondent and from former counsel for the applicant, made an order that the hearing would resume today, February 24, 2020 for a one day in-person hearing on the sole issue of the applicant’s entitlement to income replacement benefits. He ordered that the balance of the issues would be dealt with by a hearing in writing. The date for submissions on those issues was to be set at the hearing today.
12Adjudicator Watt ordered that the date of February 24, 2020, was peremptory to the applicant. If he failed to appear today, the applicant’s entire application might be dismissed.
13The applicant has not appeared today, nor has anyone on his behalf. Counsel for the respondent attended, and submitted that since January 13, 2020, the respondent has written to the applicant several times and has had no response. The respondent has left messages for the applicant by telephone but has had no reply.
14I have reviewed the Tribunal’s file and note that several efforts have also been made by the Tribunal to contact the applicant, without success.
15The applicant has the obligation to prove to the Tribunal his entitlement to the benefits sought in this application, by clear and persuasive evidence. He has failed to lead any such evidence.
16Accordingly, this application will be dismissed in its entirety.
ORDER
17The application is dismissed.
Released: April 2, 2020
Patricia Conway
Adjudicator