Licence Appeal Tribunal File Number: 21-011821/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:
Sher Ahmad Khan
Applicant
and
Echelon General Insurance Company
Respondent
DECISION
ADJUDICATOR: Ulana Pahuta
APPEARANCES:
For the Applicant: No one appearing
For the Respondent: No one appearing
HEARD: By way of written submissions
OVERVIEW
1Sher Ahmad Khan, the applicant, was involved in an automobile accident on July 27, 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, Echelon General Insurance Company, 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. Is the applicant entitled to chiropractic, physiotherapy and massage therapy treatments proposed by Canadian Active Rehabilitation Centre, as follows:
(i) $4,613.93, submitted October 21, 2019 and denied December 13, 2019?
(ii) $4,966.22, submitted July 30, 2019 and denied September 5, 2019?
ii. Is the applicant entitled to $2,350.00 for a neurological assessment proposed by Canadian Active Rehabilitation Centre, submitted August 14, 2019, denied September 18, 2019?
iii. Is the applicant entitled to $2,000.00 for an occupational therapist assessment proposed by Neuro-Rehab Services Inc., submitted October 9, 2019 and denied October 11, 2019?
iv. Is the respondent liable to pay an award under s. 10 of Regulation 664 because it unreasonably withheld or delayed payments to the applicant?
v. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
3The application is dismissed. The applicant has not met his evidentiary burden to establish these treatment plans are reasonable and necessary pursuant to ss. 15 and 16 of the Schedule. Given there are no benefits payable, interest is not applicable. The applicant has not established entitlement to an award.
ANALYSIS
4The onus is on the applicant to demonstrate that he is entitled to the benefits claimed. He made no submissions and tendered no evidence in support of his claims before the Tribunal. Therefore, I find that the applicant has failed to meet his onus and dismiss the application.
5Both parties attended the case conference conducted on August 5, 2022. A written hearing was scheduled for May 26, 2023 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 April 25, 2023 and the respondent was required to provide its written submissions by May 12, 2023. Finally, the applicant was required to file written reply submissions by May 19, 2023.
7The Tribunal did not receive any correspondence from either party leading up to the written hearing.
8More than three months have now elapsed since the written submission deadlines and the hearing set for May 26, 2023. The parties have been afforded ample time to provide submissions, a procedural update or file a Notice of Withdrawal, and have failed to do so.
9Given the applicant’s failure to provide any hearing submissions or evidence, it is clear the applicant has not met his evidentiary burden with regard to the issues in dispute. This application shall be dismissed.
ORDER
10The applicant has not met his evidentiary burden to establish that the treatment plans are reasonable and necessary pursuant to ss.15 and 16 of the Schedule. As a result, he is not entitled to the treatment plans in issue, applicable interest, or an award.
11The application is dismissed.
Released: October 13, 2023
__________________________
Ulana Pahuta
Adjudicator