Reis v. Aviva Insurance Company, 2023 CanLII 30770

Citation: Reis v. Aviva Insurance Company, 2023 ONLAT 20-013438/AABS - R

RECONSIDERATION DECISION

Before: Rebecca Hines, Adjudicator

Licence Appeal Tribunal File Number: 20-013438/AABS

Case Name: Alfredo Reis v. Aviva Insurance Company

Written Submissions by:

For the Applicant: Dominik Gora, Counsel

For the Respondent: April C Snow, Counsel

BACKGROUND

1This reconsideration request follows a Tribunal decision dated January 23, 2023, in which I determined that the applicant was not entitled to four treatment plans for chiropractic and kinesiology treatment.

2The applicant has requested a reconsideration of my decision and argues that I erred in fact and law in rendering my decision. He argues that had these errors not been made I would have reached an alternative decision.

3The respondent argues that my decision is correct. Further, the applicant is simply relitigating his position which already failed at the hearing.

RESULT

4The applicant's request for reconsideration is dismissed.

RECONSIDERATION CRITERIA

5Rule 18 of the Licence Appeal Tribunal, Animal Care Review Board, and Fire Safety Commission Common Rules of Practice and Procedure (Effective February 7, 2019 ("Rules") states that a request for reconsideration will not be granted unless one or more of the following criteria are met:

(i) The Tribunal acted outside its jurisdiction or violated the rules of natural justice or procedural fairness;

(ii) The Tribunal made an error of law or fact such that the Tribunal would likely have reached a different decision;

(iii) The Tribunal heard false or misleading evidence from a party or witness, which was discovered only after the hearing and would have affected the result; or

(iv) There is new evidence that could not have reasonably been obtained earlier and would have affected the result.

6The following remedies are available to the Tribunal on a request for reconsideration:

(i) dismiss the request;

(ii) confirm, vary or cancel the decision or order; or

(iii) order a rehearing on all or part of the matter.

7The applicant relies on Rule 18.2(b), arguing that I erred in fact and law in finding that:

a) the family doctor's clinical notes and records reflect the applicant's self-reports;

b) in not concluding that the applicant ceased complaining of neck pain in January 2019 because he made improvements because of all of the treatment he had received; and

c) in finding that the functional impairment evaluations between 2017 and 2020 contained inconsistent results as far as improvements to the applicant's range of motions and strength.

8The applicant submits that had I not made the above-noted errors of law, I would have reached an alternative decision in his favour.

ANALYSIS

9The applicant's request for reconsideration is denied for the following reasons.

10I agree with the respondent that the applicant is relitigating his position that already failed at a hearing. That is not the purpose of the reconsideration process.

11In my decision dated January 23, 2023, I provided very detailed reasons for not finding the disputed treatment plans reasonable and necessary. First, I determined that the amount of the treatment recommended was excessive and the cost was not reasonable. Second, I found the improvements noted in between OCF-18s to be vague and lacking in detail. Third, I was not convinced that the stated objectives of increasing the applicant's strength and improving his range of motion would be achieved because of inconsistencies in the evidence. Finally, I did not find the applicant's testimony credible.

12Even if I did not mention the family doctor's reference to reduced range of motion in a few of the clinical notes and records this would not result in an alternative decision. Nor has the applicant convinced me that I erred by not concluding that he ceased complaining of neck pain because of all of the improvements he made from treatment. Finally, I do not find I erred in finding that there were inconsistent results in the functional impairment evaluations.

13It is well established law that the threshold for reconsideration is a high one. The purpose of the reconsideration process is not for the losing party to relitigate issues that already failed at the hearing. In my view, that is what the applicant has done in this reconsideration request.

14The applicant has failed to convince me on a balance of probabilities that I made an error of fact and/or law which would result in an alternative decision regarding the issues in dispute.

15This request for reconsideration is dismissed.

Rebecca Hines Adjudicator Tribunals Ontario – Licence Appeal Tribunal