Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 22-005853/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:
Latoya Manning
Applicant
and
Commonwell Mutual Insurance
Respondent
DECISION
ADJUDICATOR: Laura Goulet
APPEARANCES:
For the Applicant: Latoya Manning, Applicant (Did not attend) Esan Ince-Mercer, Counsel (Did not attend)
For the Respondent: Savi Singh, Claims Adjuster Cecil Jaipaul, Paralegal
HEARD: by Videoconference: August 8, 2023
OVERVIEW
1Latoya Manning, the applicant, was involved in an automobile accident on November 10, 2018, 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, Commonwell Mutual Insurance, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the "Tribunal") for resolution of the dispute.
2Following the January 9, 2023 Case Conference which all parties attended, this matter was scheduled for a 3-day videoconference hearing. A Notice of Videoconference Hearing was sent to the applicant's counsel by fax and email on March 10, 2023. The applicant and their counsel did not attend today's hearing, nor did they file a document brief. The respondent and their representative were present.
3The hearing videoconference remained open until 10:04 a.m., however, neither the applicant nor her counsel was present. A case management officer from the Tribunal attempted to reach the applicant's counsel on the morning of the hearing, and the week prior, but was not able to make contact by email or phone.
4In my view, it is appropriate for today's hearing to proceed in the absence of the applicant pursuant to section 7(3) of the Statutory Powers Procedures Act, R.S.O. 1990, c. S.22. I am satisfied the applicant received notice of today's videoconference hearing on March 10, 2023. In keeping with Rule 3.1 of the Tribunal's Common Rules of Practice and Procedure, I find that proceeding with the hearing is an efficient and proportional resolution of this dispute.
ISSUES IN DISPUTE
5The preliminary issues to be decided are:
i. Is the applicant barred from proceeding to a hearing for a non-earner benefit ("NEB") because the applicant did not dispute their denial within the 2-year limitation as per s. 56 of the Schedule?
ii. Is the applicant barred from proceeding to a hearing for a NEB because she qualified for an income replacement benefit ("IRB") as per s. 12 of the Schedule?
iii. Did the applicant make a material misrepresentation that induced the respondent to enter into the contract of automobile insurance or intentionally fail to notify the respondent of a change of risk material to the contract which relieves the respondent of its obligation to pay an IRB, NEB, education expenses, visitor expenses, or housekeeping and home maintenance pursuant to s. 31(1)(b) of the Schedule?
6The issues in dispute are:
i. 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 ("MIG") limit?
ii. Is the applicant entitled to a NEB of $185.00 per week from December 8, 2018 to November 18, 2020?
iii. Is the applicant entitled to $1,533.72 for chiropractic services, proposed by Abbey Lane Chiropractic in a treatment plan/OCF-18 ("plan") dated June 7, 2021 and denied June 10, 2021?
iv. Is the applicant entitled to $2,200.00 for a psychological assessment, proposed by Marigold Medical Assessment Centre in a plan dated May 1, 2022 and denied June 7, 2022?
v. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
7The applicant did not provide any evidence to the Tribunal in support of her claim. As a result, she has not satisfied her burden to demonstrate entitlement to the benefits in dispute.
ANALYSIS
The applicant's application is dismissed
8The applicant failed to attend the hearing and failed to present a case. As it is the applicant's burden to demonstrate entitlement to the benefits in dispute, and where the Tribunal was not presented with evidence from the applicant in support of her application, it follows that the applicant cannot be successful with her claim. I find that the applicant is not entitled to any of the benefits claimed.
ORDER
9The applicant is not entitled to any of the benefits in dispute, as she failed to attend the hearing or present a case to support her application.
10The application is dismissed.
11The preliminary issues are dismissed as moot without prejudice to the respondent to raise them again.
Released: September 26, 2023
Laura Goulet Adjudicator