L.P. v. Unifund Assurance Company
RECONSIDERATION DECISION
Before: Ian Maedel, Vice Chair
Tribunal File Number: 20-013592/AABS
Case Name: L.P. v. Unifund Assurance Company
Written Submissions by:
For the Applicant: Ryan M. Jeffries, Paralegal
For the Respondent: Sean R. Chambers, Counsel
OVERVIEW
1This request for a reconsideration was filed by the respondent and arises out of a Motion Order dated January 8, 2021. The Tribunal concluded that a treatment plan was payable in its entirety pursuant to s. 38(8) of the Schedule.
2The respondent submits that the Tribunal made an error of law or fact such that the Tribunal would likely have reached a different result had the error not been made.
3The respondent is seeking an order varying the Tribunal’s Motion Order dated January 8, 2021.
RESULT
4The respondent’s request for reconsideration is dismissed.
PARTIES’ POSITIONS
5The respondent submits the Tribunal erred in its application of s. 38(11)(2), as the respondent is not required to pay for the treatment plan it in its entirety. The respondent is only liable to pay for incurred treatment that was rendered between the deficient Explanation of Benefits dated November 11, 2020 and the cured Explanation of Benefits (“EOB”) dated December 2, 2020. The respondent further submits that no evidence of incurred treatment was provided by the applicant.
6The applicant submits there was no error of law, as there was no explicit finding that the medical and other reasons provided in the second EOB were compliant with the minimum requirements of s. 38(8). Neither of the EOB’s provided were compliant with ss. 38(8) or 44(5), therefore the entirety of the treatment plan at issue was payable as per the Tribunal Order.
ANALYSIS
7This issue is now moot. The applicant has served a Notice of Withdrawal dated May 25, 2021. The Tribunal confirmed the closure of this application on May 26, 2021.
8The Tribunal now lacks jurisdiction over this matter, as there is no longer a “dispute” regarding the entitlement or quantum of accident benefits pursuant to ss. 280(1) or (2) of the Insurance Act. In other words, when the application was withdrawn, the Tribunal lost the jurisdiction to consider this matter any further.
9There is no residual authority in the Insurance Act, Schedule, Licence Appeal Tribunal Act, or any other applicable statute that would otherwise preserve Tribunal jurisdiction over this matter following the withdrawal of the application.
CONCLUSION
10For the reasons noted above, I deny the respondent’s request for reconsideration.
11The Tribunal file shall remain closed.
Ian Maedel
Vice Chair
Tribunals Ontario – Licence Appeal Tribunal
Date of Issue: May 31, 2021