Licence Appeal Tribunal
19-008420/AABS
Released Date: 02/16/2021
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:
Esperanza Dias
Applicant
and
Certas Home and Auto Insurance Company
Respondent
DECISION AND ORDER
ADJUDICATOR:
Monica Chakravarti
APPEARANCES:
For the Applicant:
Jessie Tran, Paralegal
For the Respondent:
Celina Aguero, Counsel
HEARD:
Via Written Submissions
OVERVIEW
1The applicant was involved in an automobile accident on March 24, 2015 and sought benefits from the respondent pursuant to the Statutory Accident Benefits Schedule –Effective September 1, 20101. The respondent denied these benefits and the applicant then filed an application with the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) to resolve the dispute.
ISSUES TO BE DECIDED
2The following are the issues to be decided:
a. Are the applicant’s injuries predominantly minor as defined in section 3 of the Schedule and therefore subject to treatment within the $3,500.00 limit and in the Minor Injury Guideline (MIG)?
b. If the applicant’s injuries are not considered to be within the Minor Injury Guideline, then:
i. Is the applicant entitled to $2,600.00 for massage, acupuncture and chiropractic treatment recommended by York Medical Centre as outlined the treatment and assessment plan dated July 20, 2017 and denied by the respondent on August 3, 2017?
ii. Is the applicant entitled to $2,600.00 for massage, acupuncture and chiropractic treatment recommended by York