Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 23-001283/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:
Hasan Jouda
Applicant
and
Royal Sun Alliance
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: Navjot Banipal, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Hasan Jouda, the applicant, was involved in an automobile accident on August 23, 2020, 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, Royal Sun Alliance, 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 October 6, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for May 31, 2024, with the Notice of Written Hearing e-mailed to the parties on October 12, 2023.
3The applicant’s initial submissions were due on May 1, 2024. The applicant has not provided any written submissions to the Tribunal. There has also been no Notice of Motion filed seeking to extend the initial submissions deadline.
4The respondent filed submissions with the Tribunal stating it has not received submissions from the applicant. It is seeking a dismissal of the application.
ISSUES
5As listed in the case conference report and order, the substantive 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 $1,995.33 for psychological services, proposed by Seksek Chiropractic Professional Corporation in a treatment plan/OCF-18 (“plan”) dated February 1, 2021?
iii. Is the applicant entitled to $2,668.27 for physiotherapy services, Assessment, proposed by Seksek Chiropractic Professional Corporation in a treatment plan dated May 3, 2021?
iv. Is the applicant entitled to $2,200.00 for physiotherapy services, proposed by Seksek Chiropractic Professional Corporation in a treatment plan dated January 10, 2023?
v. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
vi. Is the applicant entitled to interest on any overdue payment of benefits?
6The following preliminary issue is also listed in the case conference report and order:
i. Is the applicant barred from proceeding to a hearing for all of the benefits claimed in this application because the applicant failed to attend an insurer’s examination under s. 44 of the Schedule?
ANALYSIS
7Section 7(2) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 states that, if notice of a written hearing has been given to a party who does not then participate in the hearing in accordance with the notice, the Tribunal may proceed with the hearing in the absence of that party’s participation. I am satisfied that both parties received notice of the written hearing, so I shall proceed without submissions from the applicant.
8The applicant has the onus of demonstrating removal from the Minor Injury Guideline, as well as entitlement to the medical benefits, award, and interest in dispute. By not filing any submissions or evidence with the Tribunal, I find that the applicant has not met this burden.
9I further find that the applicant did not file a Notice of Motion requesting an extension of the initial submission deadline.
10Due to my finding regarding the substantive issues in dispute, I conclude the preliminary issue is now moot.
ORDER
11As 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 Minor Injury Guideline, nor has the applicant demonstrated entitlement to the medical benefits, award, and interest in dispute.
12The preliminary issue listed in the case conference report and order is moot.
13The application is dismissed.
Released: November 27, 2024
Craig Mazerolle
Vice-Chair