Licence Appeal Tribunal File Number: 20-014025/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:
The Late Lisa Terrell
Applicant
and
Intact Insurance Company
Respondent
DECISION
VICE-CHAIR:
Tyler Moore
APPEARANCES:
For the Respondent:
Monique Quintal, Senior Adjuster
Mary-Catherine Lill, Counsel
HEARD: by Videoconference:
October 16, 2023
OVERVIEW
1The Late Lisa Terrell, the applicant, was involved in an automobile accident on June 10, 2018, 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, Insurer, 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. Has the applicant sustained a catastrophic impairment as defined by the Schedule?
ii. Is the applicant entitled to attendant care benefits in the amount of $6,000.00 per month from June 10, 2018 to date and ongoing?
iii. Is the applicant entitled to $1,900.00 for medical services proposed by Dr. Riaz Moolla in a treatment plan/OCF-18 (“plan”) which was denied on January 24, 2019?
iv. Is the applicant entitled to $1,349.99 for assistive devices proposed by MediCase Group in a treatment plan which was denied on August 28, 2019?
v. Is the applicant entitled to $5,790.00 for medical services proposed by MediCase Group in a treatment plan which was denied on August 29, 2019?
vi. Is the applicant entitled to housekeeping and home maintenance benefits of $100.00 per week from June 10, 2018 to date and ongoing?
vii. Is the respondent liable to pay an award under s.10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
viii. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
3The application is dismissed. I find that the applicant has not met her evidentiary burden with regard to establishing entitlement to the issues in dispute.
Backgrouind
4On May 12, 2021, the Tribunal ordered that a 5-day oral be scheduled for this matter. The oral hearing was adjourned on January 21, 2022, because the parties were awaiting IE reports and responding addendums.
5On November 21, 2022, the Tribunal granted a second adjournment, on consent, after being informed that the applicant had passed away on October 21, 2022. An estate trustee needed to be assigned by the courts.
6On June 12, 2023, the deceased applicant’s counsel of record filed a Notice of Motion seeking to remove himself as counsel. At the time, counsel submitted that he had tried multiple times to contact the deceased applicant’s daughter, Amy Terrell, unsuccessfully and he was unaware of any Estate executor. On July 11, 2023, the applicant’s counsel of record was removed by the Tribunal. The Motion Order was mailed to the applicant’s last known address.
7On October 12, 2023, a videoconference hearing link was mailed to the deceased applicant’s last known address and emailed to her daughter.
8Unfortunately, nobody attended the oral hearing scheduled for October 16, 2023 on behalf of the deceased applicant. The applicant’s daughter has made no attempts to contact the Tribunal since the passing of her mother in October 2022, and the Tribunal has received no indication that an estate trustee or executor has been appointed or is in the process of being appointed.
ANALYSIS
9Proceeding with an oral hearing where a party fails to participate, under s. 7(1) of the Statutory Powers Procedure Act, RSO 1990, c. S.22 (“SPPA”) requires the Tribunal to be satisfied that the absent party received notice of the oral hearing.
10The respondent submitted that the applicant passed away in October 2022 and that there has been no communication from a representative for the deceased applicant’s Estate since that time. In addition, the respondent has received no documents, evidence, or hearing witness list for the hearing.
11I find that the Tribunal has made every available effort to provide reasonable notice of the oral hearing to the parties. The Tribunal mailed a notice of hearing to the deceased applicant’s last known address and emailed a notice of hearing to the deceased applicant’s daughter, Amy Terrell, using the contact information provided. Despite notices being sent by regular mail and by email, nobody attended the hearing on behalf of the deceased applicant. In accordance with s. 7(1) of the SPPA, I proceeded with the hearing.
12I find that the applicant failed to meet her evidentiary onus for entitlement to any of the claimed benefits in dispute. No documentary evidence or witness list related to the oral hearing was filed for consideration on her behalf.
13In the absence of any supportive evidence from the applicant, this application shall be dismissed.
ORDER
14As the applicant has not met her evidentiary burden, the application is dismissed.
Released: November 17, 2023
Tyler Moore
Vice-Chair