Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 22-013824/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:
SUNNY SHARMA
Applicant
and
Allstate Insurance Company of Canada
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: No submissions
Written Hearing: Heard by way of written submissions
OVERVIEW
1Sunny Sharma, the applicant, was involved in an automobile accident on February 20, 2015, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (the “Schedule”). The applicant was denied benefits by the respondent, Allstate Insurance Company of Canada, 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 $6,934.30 for planning services, proposed by 101 Assessments in a treatment plan dated November 30, 2022?
ii. Is the applicant entitled to $6,238.95 for case management services, proposed by Isabelle Zonenberg Case Management in a treatment plan dated June 29, 2023?
iii. Is the applicant entitled to $695.39 ($7,629.69 less $6,934.30 approved) for case management services, proposed by 101 Assessments in a treatment plan dated June 1, 2023?
iv. Is the applicant entitled to $695.39 ($6,934.34 less $6,238.95 approved) for case management services, proposed by 101 Assessments in a treatment plan dated January 6, 2023?
v. Is the applicant entitled to the assessments proposed by 101 Assessments, as follows:
i. $1,525.50 for an Environmental Assessment, in a treatment plan dated November 8, 2022; and
ii. $2,460.00 for an Environmental Assessment, in a treatment plan dated December 22, 2021?
iii. $2,460 for a Total Body Assessment, in a treatment plan dated December 12, 2021?
iv. $2,460.00 for a Psychological Assessment, in a treatment plan dated November 17, 2021?
v. $2,460.00 for a Total Body Assessment, in a treatment plan dated May 8, 2023?
vi. $5,590.00 for a Future Care Cost Assessment, in a treatment plan dated May 11, 2023?
vii. $3,475.59 for an Attendant Care Assessment, in a treatment plan dated May 19, 2023?
vi. Is the applicant entitled to $695.01 ($3,089.01 less $2,394.00 approved) for an Attendant Care Form, submitted on a claim form dated November 8, 2022?
vii. Is the applicant entitled to $4,720.00 for transportation costs, submitted on a claim form dated May 11, 2023?
viii. Is the applicant entitled to $4,855.95 ($9,195.13 less $4,339.18 approved) for assistive devices, submitted on a claim form dated April 18, 2023?
ix. Is the applicant entitled to $1,912.40 ($5,276.57 less $3,364.17 approved) for assistive devices, submitted on a claim from dated November 28, 2022?
x. Is the applicant entitled to $4,865.04 ($14,060.17 less $9,195.13 approved) for assistive devices, submitted on a claim form dated November 30, 2022?
xi. Is the applicant entitled to $1,782.01 ($5,146.18 less $3,364.17 approved) for assistive devices, submitted on a claim form dated November 28, 2022?
xii. Is the respondent liable to pay an award under s. 10 of O. Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
xiii. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3The applicant has the onus of demonstrating entitlement to the issues in dispute.
4In the case conference report and order released on July 24, 2023, the Tribunal ordered the dispute to proceed to a written hearing.
5The Tribunal scheduled a written hearing for April 12, 2024. Notice of this written hearing was e-mailed to the parties on July 27, 2023.
6The applicant’s initial written submissions were due on March 13, 2024. The applicant has not filed any written submissions, and there has been no Notice of Motion made seeking to extend the applicant’s initial submissions deadline.
7The respondent has not filed any submissions for this written hearing.
8As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not met the evidentiary burden. I further find that no Notice of Motion has been filed seeking to extend the applicant’s initial submissions deadline.
ORDER
9As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated entitlement to the issues in dispute.
10The application is dismissed.
Released: October 25, 2024
Craig Mazerolle
Vice-Chair