Licence Appeal Tribunal File Number: 21-004117/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:
Abdullahi Gaas
Applicant
and
The Co-operators General Insurance Company
Respondent
DECISION AND ORDER
ADJUDICATOR:
Christopher Evans
APPEARANCES:
For the Applicant:
No One Appeared
For the Respondent:
Daniel M. Himelfarb, Counsel
Heard by Videoconference:
September 12, 2022
REASONS FOR DECISION AND ORDER
BACKGROUND
1The applicant was involved in an automobile accident on March 13, 2020, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016).1 The applicant was denied certain benefits by the respondent and submitted an application to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”).
2A three-day hearing was scheduled, starting at 9:30 A.M. on September 12, 2022. When the applicant did not attend despite having received notice of the hearing, it proceeded without his participation pursuant to s. 7(3) of the Statutory Powers Procedure Act, RSO 1990, c S.22 (“SPPA”).
ISSUES
3The issues in dispute were set out in the Case Conference Report and Order (“CCRO”) of March 23, 2022 as follows:
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?
Is the applicant entitled to a non-earner benefit of $185.00 per week from March 13, 2020 to the two-year mark, with deductible period?
Is the applicant entitled to medical benefits proposed by Fern Wellness Clinic Inc. as follows:
i. $1,353,72 for chiropractic services, in a treatment plan/OCF-18 (“plan”) submitted on August 24, 2020 and denied on September 2, 2020; and
ii. $1,553.72 for chiropractic services, in a plan submitted on October 26, 2020 and denied on November 4, 2020?
- Is the applicant entitled to the assessments proposed by Community Health and Counselling Services Inc. as follows:
i. $2,179.22 for a mental health assessment, in a plan submitted on November 6, 2020 and denied on November 19, 2020; and
ii. $2,200.00 for a chronic pain assessment, in a plan submitted on November 7, 2020 and denied on November 19, 2020?
- Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
4The application is dismissed.
PROCEDURAL HISTORY
5A case conference was held on March 11, 2022, which the applicant attended. On consent, a three-day videoconference hearing was scheduled for September 12-14, 2022, starting at 9:30 A.M.
6On June 28, 2022, counsel for the applicant wrote to the Tribunal requesting that he be removed as counsel of record due to a breakdown in communication with the applicant.
7The Tribunal sent a Notice of Videoconference Hearing to both parties by email on July 22, 2022, and to the applicant by mail on August 4, 2022. The Notice states: “If you do not attend the hearing, the Tribunal may make a decision in your absence and you will not be entitled to any further notice in the proceeding.”
8The Tribunal provided the videoconference hearing link and other information to the parties by email on September 9, 2022.
9When the hearing began on September 12, 2022, the respondent was in attendance but not the applicant. The respondent advised:
a. It repeatedly attempted to contact the applicant by mail and email after his counsel was removed from the record, and did not receive a response.
b. The applicant did not produce documents, serve and file a witness list, or serve and file a document book as required by the CCRO.
10The Tribunal attempted to contact the applicant by telephone, but both numbers on file were out of service.
11After waiting until 10:10 A.M., I ordered that the hearing proceed in the applicant’s absence. The respondent did not call any evidence.
ANALYSIS
12Section 7(3) of the SPPA provides that where notice of an electronic hearing has been given to a party in a proceeding in accordance with the Act, and the party neither requests that the hearing proceed as an oral in-person hearing pursuant to s. 6(5(c) nor participates in the hearing in accordance with the notice, the Tribunal may proceed without the party’s participation and the party is not entitled to any further notice in the proceeding.
13The applicant failed to attend the hearing. The Tribunal provided notice of the hearing by email and mail, and there is no record that he requested an oral in-person hearing pursuant to s. 6(5)(c) of the SPPA. Therefore, the hearing could proceed without his participation.
14The onus is on the applicant to prove that he is entitled to the benefits and assessments in dispute and interest. Because he did not tender any evidence or make any submissions, he has not met that onus.
ORDER
15The application is dismissed.
Released: January 4, 2023
Christopher Evans
Adjudicator