Licence Appeal Tribunal File Number: 21-014772/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:
Darlene Mealey
Applicant
and
Intact Insurance
Respondent
DECISION AND ORDER
ADJUDICATOR:
Lyndra Griffith
APPEARANCES:
For the Applicant:
Darlene Mealy, self-represented, did not attend
For the Respondent:
Barb Ironside, Adjuster
Robbie Brar, Counsel
HEARD: by Videoconference:
April 18, 2023
OVERVIEW
1The applicant was involved in an automobile accident on March 5, 2019 and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016). 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.
2A one-day hearing was scheduled to begin on April 18, 2023, on the issues of non-earner benefit, the Minor Injury Guideline and medical benefits.
3This videoconference hearing was scheduled with written submissions submitted prior to the hearing.
4The notice of hearing was sent by the Tribunal to the applicant's email and home address. The notice of hearing provided contact numbers for applicants who require accommodation to participate in a Tribunal proceeding and information about the Tribunal's processes.
5On April 6, 2023, Adriano Pranzitelli emailed the Tribunal and requested to be removed as counsel of record for the applicant in this matter because counsel has not been in contact with the applicant since November 2022.
6The Tribunal contacted the applicant and confirmed that she was aware of the hearing scheduled for April 18, 2023 at 9:30 A.M.
7The respondent confirmed that it also attempted to contact the applicant but received no response. The respondent also submitted that it sent a copy of the documents for the hearing to the applicant.
8At the hearing, the applicant did not attend. The matter was stood down for 20 minutes to allow the applicant to attend.
9Section 7(3) of the Statutory Powers Procedure Act ("SPPA") permits this Tribunal to proceed with the electronic hearing, i.e., by video, where a party fails to attend. I must then be satisfied that a proper Notice of Hearing was issued to the applicant. Sections 6(1), 6(2) and 6(5) of the SPPA specify the information required to be in a proper Notice of Hearing. This includes the date, time, purpose and the details about the manner in which the hearing will be held. Having reviewed the Notice of Hearing for this video hearing, I find that it contains the required information. Further, s. 6(5)(c) of the SPPA requires that the Notice of Hearing inform all parties that they may request an oral hearing, i.e., in-person, where the requesting party can satisfy the Tribunal that it would be significantly prejudiced by an electronic hearing. Having reviewed the Tribunal's file for this matter, I find no such request by the applicant and no Tribunal order changing the hearing format. I am satisfied that this video hearing was convened properly, and that the applicant was sent a proper Notice of Hearing to her address on file.
ISSUES
10The issues to be decided in the videoconference hearing 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 Minor Injury Guideline limit? Note: The parties agree the MIG limits have not been exhausted and their submission shall identify the amounts remaining.
Is the applicant entitled to $3,548.40 for physiotherapy services, proposed by Danforth Health Services in a treatment plan/OCF-18 ("plan") dated October 16, 2019?
Is the applicant entitled to a non-earner benefit of $185.00 per week from December 2, 2019, to date and ongoing?
Is the applicant entitled to $3,641.65 for physiotherapy services, proposed by Danforth Health Services in a treatment plan/OCF-18 ("plan") dated November 19, 2020?
Is the applicant entitled to $2,200 for physiotherapy services, proposed by Princeton Hill Medical in a treatment plan/OCF-18 ("plan") dated June 3, 2020?
Is the applicant entitled to $12,497.04 for physiotherapy services, proposed by Princeton Hill Medical in a treatment plan/OCF-18 ("plan") dated October 31, 2020?
Is the applicant entitled to $2,200.00 for psychological services, proposed by Princeton Hill Medical in a treatment plan/OCF-18 ("plan") dated June 1, 2020?
Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
11The applicant is not entitled to a non-earner benefit, and she is not entitled to the medical benefits in dispute or interest, as she failed to demonstrate that removal from the Minor Injury Guideline is warranted.
ANALYSIS
12The applicant bears the burden of proving that her accident-related impairments are not within the Minor Injury Guideline. Further, the applicant bears the burden of proving both her entitlement to a non-earner benefit or medical benefits and the amount of such benefit on a balance of probabilities.
13As a result of the applicant not providing any submissions or evidence for the purpose of the hearing, the applicant has not presented a case and therefore has not met her burden of proof.
ORDER
14The application is dismissed.
Released: May 1, 2023
Lyndra Griffith
Adjudicator