Licence Appeal Tribunal File Number: 21-012213/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:
Maimuna Elias
Applicant
and
Wawanesa Insurance
Respondent
DECISION
ADJUDICATOR:
Ulana Pahuta
APPEARANCES:
For the Applicant:
Olga Poznyakova, Paralegal
For the Respondent:
James Schmidt, Counsel
HEARD:
By way of written submissions
OVERVIEW
1Maimuna Elias, the applicant, was involved in an automobile accident on January 15, 2020, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, Wawanesa Insurance, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
ISSUES
2The issues in dispute are:
i. Is the applicant entitled to a non-earner benefit of $185.00 per week from February 14, 2020 to January 15, 2022?
ii. Are the applicant’s injuries predominantly minor as defined in s. 3 of the Schedule and therefore subject to treatment within the $3,500.00 limit and in the Minor Injury Guideline?
iii. Is the applicant entitled to $1,755.98 [$3,930.32 less $2,174.34 approved] for physiotherapy services, proposed by Doctor Medical Rehabilitation Centre in a treatment plan dated July 2, 2020?
iv. Is the applicant entitled to $5,685.00 for pain injections, proposed by Al CAT Assessment Inc. in a treatment plan dated May 5, 2021?
v. Is the applicant entitled to $2,200.00 for a comprehensive pain management evaluation, proposed by Al CAT Assessment Inc. in a treatment plan dated January 12, 2021?
vi. Is the respondent liable to pay an award under s. 10 of Regulation 664 because it unreasonably withheld or delayed payments to the applicant?
vii. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
3I find that:
i. The applicant is entitled to payment of a non-earner benefit from February 14, 2020 to March 2, 2020, plus interest in accordance with s. 51 of the Schedule. The applicant is not entitled to the benefit for the

