Citation: Salnikov v. TD Insurance Meloche Monnex, 2023 ONLAT 20-013835/AABS
Licence Appeal Tribunal File Number: 20-013835/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:
Natalya Salnikov
Applicant
and
TD Insurance Meloche Monnex
Respondent
AMENDED DECISION
VICE-CHAIR: Ian Maedel
APPEARANCES:
For the Applicant: No one appearing
For the Respondent: Amanda Colorossi Colarossi, Counsel
HEARD: By way of written submissions
OVERVIEW
1Natalya Salnikov, the applicant, was involved in an automobile accident on January 30, 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, TD Insurance Meloche Monnex, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
ISSUES
2The issue(s) in dispute is/are:
i. Are the applicant’s injuries predominantly minor as defined by the Schedule and subject to the $3,500.00 treatment limit under the Minor Injury Guideline (“MIG”)?
ii. Is the applicant entitled to receive medical benefits in the amount of $998.88 for chiropractic services rendered by 2430307 Ontario Ltd. in a treatment plan dated February 13, 2020?
iii. Is the applicant entitled to receive medical benefits in the amount of $225.60 for pre-screen orthopaedic recommended by 2430307 Ontario Ltd. dated September 25, 2020?
iv. Is the applicant entitled to receive medical benefits/cost of examination in the amount of $2,000.00 for services recommended by 2430307 Ontario Ltd. in a treatment plan dated July 28, 2020?
RESULT
3The application is dismissed. The applicant has not met her evidentiary burden to establish her accident-related impairments fall outside of the definition of a minor injury in s. 3 of the Schedule. The applicant is not entitled to the treatment plans at issue, as they are not reasonable and necessary.
ANALYSIS
4The onus is on the applicant to demonstrate that she is entitled to the benefits claimed. She made no submissions and tendered no evidence in support of her claims before the Tribunal. Therefore, I find that the applicant has failed to meet her onus and dismiss the application.
5A case conference was conducted on April 12, 2021. A written hearing was scheduled for October 25, 2021 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 September 27, 2021 and written reply submissions by October 14, 2021.
7The applicant failed to comply with the CCRO and failed to provide any submissions by the deadlines imposed by the Tribunal.
8On September 28, 2021, the respondent sent the applicant’s legal representative email communication seeking the outstanding written hearing submissions. No submissions were ever received.
9The respondent provided written submissions by its deadline of October 7, 2021. The submissions were served on the Tribunal and the applicant’s legal representative. The respondent provided a signed Certificate of Service dated October 7, 2021.
10No response was received from either the applicant or her legal representative. The applicant’s written hearing submissions were never filed with the Tribunal. More than eighteen months have now elapsed since the applicant’s initial submission deadline and approximately seventeen months since the written hearing set for October 25, 2021.
11The applicant has been given multiple opportunities to provide submissions, or any procedural update regarding these submissions, and has failed to do so.
12Given the applicant’s failure to provide any hearing submissions or evidence, it is clear the applicant has not met her evidentiary burden with regard to the issues in dispute. This application shall be dismissed.
ORDER
13The applicant has not met her evidentiary burden to establish her accident-related impairments fall outside of the definition of a minor injury in s. 3, nor that the treatment is reasonable and necessary pursuant to the Schedule. As a result, she is not entitled to these benefits, nor applicable interest.
14The application is dismissed.
Released: November 30, 2023
__________________________
Ian Maedel
Vice-Chair