Licence Appeal Tribunal File Number: 20-014410/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:
Rajdavinder Chahal
Applicant
and
Waterloo Insurance
Respondent
DECISION
VICE-CHAIR:
Ian Maedel
APPEARANCES:
For the Applicant:
Inna Zaremba, Paralegal
For the Respondent:
Colin MacDonald, Counsel
HEARD:
By Way of Written Submissions
OVERVIEW
1The applicant was involved in an automobile accident on August 27, 2018 and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (“Schedule”). The applicant was denied certain benefits by the respondent and submitted an application to the Licence Appeal Tribunal - Automobile Accident Benefits Service (“Tribunal”) for resolution of the dispute.
ISSUES
2The issues in dispute are:
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 (“MIG”)?
Is the applicant entitled to a medical benefit in the amount of $1,457.79 for a private living space/worksite assessment provided by Unison Medical Assessments in a treatment plan (“OCF-18”) dated September 17, 2018?
Is the applicant entitled to a medical benefit in the amount of $1,977.05 for physiotherapy treatment provided by Mackenzie Medical Rehabilitation Centre in an OCF-18 dated January 7, 2019?
Is the applicant entitled to a medical benefit in the amount of $1,384.70 for physiotherapy treatment provided by Mackenzie Medical Rehabilitation Centre in an OCF-18 dated March 4, 2019?
Is the applicant entitled to a medical benefit in the amount of $2,569.40 for physiotherapy treatment provided by Mackenzie Medical Rehabilitation Centre in an OCF-18 dated September 16, 2019?
Is the applicant entitled to interest on any overdue payment of benefits?
RELIEF
3The application is dismissed. The applicant has not met his evidentiary burden to establish his accident-related impairments fall outside of the minor injury definition in s. 3 of the Schedule. The applicant is not entitled to the assessment and treatment at issue, as they are not reasonable and necessary.
ANALYSIS
4The onus is on the applicant to demonstrate that he is entitled to the benefits claimed. He made no submissions and tendered no evidence in support of his claims before the Tribunal. Therefore, I find that the applicant has failed to meet his onus and dismiss the application.
5A case conference was conducted on May 10, 2021. A written hearing was scheduled for April 11, 2022 and specific written hearing submission deadlines were set.
6According to the Case Conference Report and Order (“CCRO”), the applicant was required to provide initial written submissions by March 14, 2022 and written reply submissions by April 4, 2022.
7The applicant failed to comply with the CCRO and failed to provide any submissions by the deadlines imposed by the Tribunal.
8The respondent provided written submissions by its deadline of March 28, 2022. The submissions were served on the Tribunal and on both the applicant and his paralegal. The respondent provided a Certificate of Service confirming service of its submissions on the applicant paralegal dated March 28, 2022.
9The Tribunal sent e-mail correspondence to the applicant and his paralegal on March 4, 2022, reminding the applicant of the submissions deadline and providing the different methods for serving documents upon the Tribunal.
10The Tribunal sent a second email correspondence to the applicant and his paralegal on March 17, 2022, reminding the applicant that the submissions deadline had lapsed and providing the different methods for serving documents upon the Tribunal.
11The Tribunal sent a third email correspondence to the applicant and his paralegal on April 8, 2022, reminding the applicant that the submissions deadline had lapsed and requesting the outstanding submissions be provided as soon as possible.
12No response was received from either the applicant or his paralegal. More than eleven months have now elapsed since the applicant’s initial submission deadline and ten months since the written hearing set for April 11, 2022.
13The applicant has had multiple opportunities to provide submissions, or any procedural update regarding these submissions, and has failed to do so.
14Given the applicant’s failure to provide any hearing submissions or evidence, it is clear the applicant has not met his evidentiary burden with regard to the issues in dispute. This application shall be dismissed.
ORDER
15The applicant has not met his evidentiary burden to establish his accident-related impairments fall outside of the Minor Injury Guideline, nor that the assessment and treatment is reasonable and necessary pursuant to the Schedule. As a result, he is not entitled to these benefits, nor any applicable interest.
16The application is dismissed.
Released: February 17, 2023
Ian Maedel
Vice-Chair