Licence Appeal Tribunal File Number: 21-011199/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:
Ali Basra
Applicant
and
Wawanesa Insurance
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: Jono Schneider, Counsel (No submissions)
For the Respondent: James Schmidt, Counsel (No submissions)
HEARD: In Writing
OVERVIEW
1Ali Basra, the applicant, was involved in an automobile accident on August 3, 2019, 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, Wawanesa Insurance, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the "Tribunal") for resolution of the dispute.
ISSES
2The issues in dispute are:
i. Is the applicant entitled to $78.72 ($2,651.36 less $2,572.64 approved) for physiotherapy services, proposed by Northview Physiotherapy in a treatment plan/OCF-18 ("plan") dated November 11, 2019?
ii. Is the applicant entitled to $625.00 ($2,825.00 less $2,200.00 approved) for physiotherapy services, proposed by Allied-Med Trauma in a plan dated November 27, 2019?
iii. Is the applicant entitled to $90.87 ($2,564.40 less $2,473.53 approved) for physiotherapy services, proposed by Complete Rehab Centre in a plan dated November 11, 2019?
iv. Is the applicant entitled to $2,822.00 ($5,082.00 less $2,260.00 approved) for a psychological assessment, proposed by Allied Med Trauma in a plan dated September 9, 2020?
v. Is the applicant entitled to an income replacement benefit in the amount of $400.00 per week from April 11, 2022 to ongoing?
vi. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
vii. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3The applicant has the onus of demonstrating entitlement to the medical benefits, income replacement benefits, award, and interest 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. The Tribunal scheduled a written hearing for April 12, 2024. Notice of this written hearing was emailed to the parties on July 27, 2023 using the contact information they provided.
5The applicant's initial written submissions were due on March 13, 2024.
6The Tribunal sent urgent follow-up correspondence to the parties by email on April 10, 2024 and again on May 2, 2024 after no written hearing submissions were received.
7Neither party has filed submissions, and there has been no motion brought seeking to extend the submission deadlines.
8Section 7(2) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 provides that where a Tribunal has given notice of a written hearing to a party to a proceeding and the party does not participate in the hearing in accordance with the notice, the Tribunal may proceed without the party's participation and the party is not entitled to any further notice in the proceeding.
9As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not met his evidentiary burden. I further find that no Notice of Motion has been filed seeking to extend the applicant's initial submissions deadline.
ORDER
10As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated entitlement to the medical benefits, income replacement benefits, award, and interest in dispute.
11The application is dismissed.
Released: October 30, 2024
__________________________
Tyler Moore
Vice-Chair