Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 21-002041/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:
Awais Ahmad
Applicant
and
Aviva General Insurance Company
Respondent
DECISION
ADJUDICATOR: Sandra Driesel
APPEARANCES:
For the Applicant: No one appeared for the applicant
For the Respondent: Marc Beddard, Adjuster Jennifer Cosentino, Counsel
Court Reporter: Devon Makse
HEARD: by Videoconference: March 13, 2023
OVERVIEW
1Awais Ahmad, the applicant, was involved in an automobile accident on January 31, 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, Aviva, 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. Are the applicant’s injuries predominantly minor as defined by the Schedule and subject to a maximum treatment limit of $3,500.00 under the Minor Injury Guideline (“MIG”)?
ii. Is the applicant entitled to $1,998.00 for the cost of an attendant care assessment, recommended by Excel Medical Diagnostics Inc., denied on August 13, 2020?
iii. Is the applicant entitled to $168.00 per week for an income replacement benefit (“IRB”) for the period from September 4, 2020, to date and ongoing, denied on August 26, 2020?
iv. Is the applicant entitled to $2,635.15 for the cost of a neurological assessment, recommended by Excel Medical Diagnostics Inc., denied on October 28, 2020?
v. Is the applicant entitled to interest on any overdue payment of benefits?
vi. Is the respondent entitled to costs?
RESULT
3The applicant has failed to meet his onus in proving that he is entitled to the benefits as claimed. As there are no benefits owing, there is no entitlement to interest. The applicant shall pay the respondent the sum of $500.00 for costs.
ANALYSIS
The applicant’s claim must fail
4On March 13, 2023, the first day of the hearing, neither the applicant nor anyone representing him appeared. The hearing was scheduled to begin at 9:30 am.
5By way of background, the applicant was represented by counsel when the Tribunal application was first filed on February 19, 2021. The applicant was also present, with counsel, at the telephone case conference of May 4, 2022, when the matter was set down for a hearing.
6On January 26, 2023, the applicant’s counsel of record advised the Tribunal and the respondent that he no longer represents the applicant and on the following day, his office provided a current email and phone number for the applicant. There was no indication that the applicant’s home mailing address had changed since the application was filed.
7The respondent advised the Tribunal on the day of the hearing that it had made several attempts to communicate with the applicant, but he failed to reply. The communications included: the respondent’s brief sent to the applicant on February 3, 2023; the respondent’s witness list sent on February 8, 2023; and a request for the applicant to advise on his intention regarding the hearing, sent on February 17, 2023 (which included a blank “Notice of Withdrawal” for the applicant to complete, if appliable).
8The Tribunal also re-sent the Notice of Hearing, dated November 21, 2022, and the videoconference link details to the applicant, on March 9, 2023, to the email and last known home postal address on file. Also, on February 27, 2023, the Tribunal followed up asking the applicant for a confirmation of his intentions regarding the hearing. The applicant failed to reply to any communications.
9Given the above, I find that the Tribunal provided reasonable notice of the hearing in accordance with section 6 of the Statutory Powers Procedure Act (“SPPA”). The applicant failed to attend after the Tribunal and the respondent sent correspondence to determine both his status regarding potential representation at the hearing and the status of his submissions for the hearing.
10By 10:15 am, I ordered that the hearing commence without the applicant. The hearing proceeded in the absence of the applicant in accordance with section 7 of the SPPA, which addresses the effect of non-attendance at a hearing by a party after due notice.
11No submissions and evidence were filed with the Tribunal on behalf of the applicant. The applicant did not file any document briefs for the hearing as ordered by the Tribunal. The respondent provided a hearing brief as ordered by the Tribunal but did not present any evidence on the substantive issues.
12Given his failure to provide submissions and to tender any evidence, I am unable to determine whether the applicant’s injuries fall outside of the MIG limits, or whether his claims for an IRB and medical assessments are reasonable or necessary. The onus is on the applicant to prove entitlement to accident benefits. In this case the applicant’s claim (the entirety of the Tribunal application) must fail for lack of evidence.