Licence Appeal Tribunal File Number: 18-004309/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:
Samuel Agyapong
Applicant
and
Aviva Insurance Canada
Respondent
DECISION
ADJUDICATOR:
Kate Grieves
APPEARANCES:
For the Applicant:
Kwaku Bona, Paralegal
For the Respondent:
Geoffrey Keating, Counsel
HEARD:
By Way of Written Submissions
OVERVIEW
1Samuel Agyapong (“the applicant”) was involved in an automobile accident on September 26, 2016, 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 Aviva Insurance Company (“the respondent”) 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 non-earner benefits in the amount of $185.00 per week from May 5, 2017 to date and ongoing?
Is the applicant entitled to attendant care benefits at the rate of $1,340.93 per month from October 26, 2017 to date and ongoing?
Is the applicant entitled to a medical benefit in the amount of $1,977.05 for chiropractic treatment recommended by Mackenzie Medical Rehabilitation Centre Inc. in a treatment plan dated March 14, 2017?
Is the applicant entitled to a medical benefit in the amount of $1,384.70 for chiropractic treatment recommended by Mackenzie Medical Rehabilitation Centre Inc. in a treatment plan dated April 24, 2017?
Is the applicant entitled to a medical benefit in the amount of $2,569.40 for chiropractic treatment recommended by Mackenzie Medical Rehabilitation Centre Inc. in a treatment plan dated July 21, 2017?
Is the applicant entitled to a medical benefit in the amount of $1,230.92 for occupational therapy services recommended by Prime Health Care Inc. in a treatment plan dated December 15, 2016?
Is the applicant entitled to a medical benefit in the amount of $1,230.92 for occupational therapy services recommended by Prime Health Care Inc. in a treatment plan dated June 22, 2017?
Is the applicant entitled to a medical benefit in the amount of $2,000.00 for a psychological assessment recommended by Prime Health Care Inc. in a treatment plan dated July 13, 2017?
Is the applicant entitled to a medical benefit in the amount of $2,758.87 for assistive devices recommended by Prime Health Care Inc. in a treatment plan dated September 27, 2017?
Is the applicant entitled to a medical benefit in the amount of $998.86 for chiropractic treatment recommended by Nor Med Assessment Services in a treatment plan dated October 19, 2016?
Is the applicant entitled to a medical benefit in the amount of $2,000.00 for an orthopaedic assessment recommended by Nor Med Assessment Services in a treatment plan dated December 29, 2016?
Is the applicant entitled to a medical benefit in the amount of $752.53 ($1,999.82 less approved $1,247.29) for a psychological assessment recommended by Nor Med Assessment Services in a treatment plan dated October 19, 2016?
Is the applicant entitled to a medical benefit in the amount of $3,352.02 for chiropractic treatment recommended by East Sheppard Rehabilitation Clinic in a treatment plan dated March 27, 2016?
Is the applicant entitled to a medical benefit in the amount of $200.00 for completion of a disability certificate (OCF-3) by Mackenzie Medical Rehabilitation Centre Inc. dated July 14, 2017?
Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
3The application is dismissed. Given that the applicant made no submissions for this hearing, I find that he has not met his evidentiary burden with regard to the benefits in dispute.
ANALYSIS
4This matter was initially scheduled to proceed orally. At the applicant’s request, the hearing was converted to a written hearing by Order dated September 8, 2022 and established deadlines for submissions and evidence anchored on the forthcoming dated for the hearing to be scheduled by the Tribunal. On April 27, 2023 the Tribunal emailed a Notice of Written Hearing to both parties that set the hearing date for December 22, 2023. The notice included provisions that the hearing adjudicator may not consider documents filed after deadlines ordered by the Tribunal, and that the Tribunal may make a decision without the participation of one or both parties if submissions are not filed.
5The applicant did not file submissions and evidence as of November 22, 2023 in accordance with the Order and Notice of Written Hearing. The respondent filed its submissions in accordance with the established deadlines.
6On December 8, 2023, the applicant filed a Notice of Motion seeking an extension of the deadline to file written submissions, or alternatively to convert the written hearing to in-person or videoconference. The motion was denied by Order dated December 21, 2023.
7No submissions have been filed by the applicant with respect to the issues in dispute. As is held in Scarlett v. Belair Insurance, 2015 ONSC 3635, the evidentiary onus is on the applicant to demonstrate that he is entitled to any claimed benefits. In the absence of any submissions or evidence filed by the applicant, I find that the applicant has failed to meet his burden to demonstrate entitlement to the benefits claimed.
ORDER
8As the applicant failed to provide any submissions, it follows that he has not met his evidentiary burden to establish entitlement to the benefits in dispute.
9The application is dismissed.
Released: January 4, 2024
Kate Grieves
Adjudicator