Licence Appeal Tribunal
Release date: 04/27/2021
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:
[WC]
Applicant
and
Aviva Insurance Canada
Respondent
DECISION
ADJUDICATOR:
Jesse A. Boyce, Vice-Chair
APPEARANCES:
For the Applicant:
No submissions
For the Respondent:
Mohamed R. Hashim, Counsel
HEARD:
By way of written submissions
OVERVIEW
1The applicant was involved in an automobile accident on May 22, 2017, and sought benefits from the respondent, Aviva, pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (the ''Schedule'').1
2The parties participated in a case conference on September 16, 2020 where the applicant was represented by counsel and by a paralegal. Pursuant to the Case Conference Report dated October 13, 2020, a written hearing was set down for March 31, 2021, with eight issues being in dispute. The applicant’s written submissions and evidence were to be filed on March 1, 2021, with Aviva’s submissions to follow on March 19, 2021. The Tribunal sent the parties a Notice of Written Hearing on February 10, 2021.
3The applicant missed their deadline for submissions. On March 2, 2021, Aviva sought and received confirmation from the Tribunal that no materials were received. The applicant did not respond to the Tribunal’s correspondence of March 2, 2021 or March 26, 2021. Via letter dated March 19, 2021, Aviva advised that since it had not received the applicant’s submissions and evidence, it had nothing to respond to. To date, no submissions from the applicant have been received.
ISSUES IN DISPUTE
4The issues in dispute were identified as follows:
(i) Is the applicant entitled to income replacement benefits at the rate of $400.00 per week ongoing from November 1, 2017?
(ii) Is the applicant entitled to a medical benefit in the amount of $1,327.90 for chiropractic services recommended by George Charalambous in a treatment plan (OCF-18) submitted on September 28, 2017, and denied on November 14, 2017?
(iii) Is the applicant entitled to a medical benefit in the amount of $2,590.84 for chiropractic services recommended by George Charalambous in a treatment plan (OCF-18) submitted October 31, 2017, and denied on November 14, 2017?
(iv) Is the applicant entitled to a medical benefit in the amount of $2,254.67 for medical services recommended by Khal Efala in a treatment plan (OCF-18) submitted November 11, 2017, and denied on November 15, 2017?
(v) Is the applicant entitled to a medical benefit in the amount of $637.38 for chiropractic services recommended by Alpha Med Wellness Centre Inc. in a treatment plan (OCF-18) submitted April 17, 2018, and denied May 1, 2018?
(vi) Is the applicant entitled to a medical benefit in the amount of $508.32 for other assistive devices recommended by Alpha Med Wellness Centre in a treatment plan (OCF-18) submitted April 17, 2018, and denied on May 1, 2018?
(vii) Is the applicant entitled to interest on any overdue payment of benefits?
(viii) Is the applicant entitled to an award under Ontario Regulation 664 because the respondent unreasonably withheld or delayed the payment of benefits?
ANALYSIS
5The applicant’s written submissions and evidence were due on March 1, 2021. To date, the applicant has not filed evidence, written submissions or a reply by their deadline and did not present a case. There is no evidence that they have attempted to contact either Aviva or the Tribunal, despite being represented. Aviva requests that the application be dismissed as abandoned.
6I agree and find that the applicant has abandoned their application. Despite proper notice, the applicant has not taken any steps to demonstrate that they intend to proceed. Further, and in any case, it is well-settled that the applicant bears the burden of demonstrating entitlement to the benefits they seek on a balance of probabilities. As they have not made submissions or filed evidence, the applicant has also failed to meet their burden. Accordingly, they are not entitled to payment for the benefits in dispute.
ORDER
7The application is dismissed.
Released: April 27, 2021
________________________
Jesse A. Boyce, Vice Chair
Footnotes
- O. Reg. 34/10, as amended.