Licence Appeal Tribunal File Number: 22-008740/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:
Angel Mejia
Applicant
and
Intact Insurance Company
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
Submissions:
Applicant: No submissions
Respondent: Christine Anne Haddad, Counsel
HEARD: In Writing
OVERVIEW
1Angel Mejia, the applicant, was involved in an automobile accident on August 14, 2017, 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, Intact Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2In a case conference report and order released on April 28, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for February 2, 2024, with the notice of written hearing e-mailed to the parties on May 11, 2023.
3The applicant’s initial submissions were due on January 3, 2024. The applicant has not provided any written submissions to the Tribunal. There has been no Notice of Motion filed by the applicant seeking to extend the initial submissions deadline.
ISSUES
4As listed in the case conference report and order, the 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 limit?
ii. Is the applicant entitled to $2,821.60 for psychological assessment proposed by Prostean Madalina, submitted February 24, 2022 and denied March 9, 2022?
iii. Is the applicant entitled to $2,821.60 for chronic pain assessment proposed by Micheal Gofeld, submitted March 8, 2022 and denied March 21, 2022?
iv. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
v. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
5The applicant has the onus of demonstrating removal from the MIG, as well as entitlement to the treatment plans, award, and interest in dispute. By not filing any submissions or evidence with the Tribunal, I find that the applicant has failed to meet this burden.
6I further find that the applicant did not file a Notice of Motion requesting an extension of the initial submissions deadline.
ORDER
7As the applicant has made no submissions and tendered no evidence in support of the claims before the Tribunal, the applicant has not demonstrated removal from the MIG, nor has the applicant demonstrated entitlement to the disputed treatment plans, award, and interest.
8The application is dismissed.
Released: October 24, 2024
Craig Mazerolle
Vice-Chair