Citation: Zhang v. Pembridge Insurance Company, 2024 ONLAT 22-012772/AABS
Licence Appeal Tribunal File Number: 22-012772/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:
Yue Xiang Zhang
Applicant
and
Pembridge Insurance Company
Respondent
DECISION
ADJUDICATOR: Nadia Mauro
APPEARANCES:
For the Applicant: Ryan Olson, Paralegal
For the Respondent: Oliver Gorman-Asal, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Yue Xiang Zhang, the applicant, was involved in an automobile accident on July 29, 2022, 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, Pembridge 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:
- Is the applicant entitled to $4,195.12 for Physiotherapy Services, proposed by Total Recovery Rehab Centre in a treatment plan (OCF-18) dated August 3, 2022?
- Is the applicant entitled to the medical services proposed by Somatic Assessments and Treatment Clinic, as follows: i. $748.00, ($2,804.10 less $2,056