Licence Appeal Tribunal File Number: 23-002484/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:
Suyi Cao
Applicant
and
TD General Insurance Company
Respondent
DECISION
ADJUDICATOR:
Amar Mohammed
APPEARANCES:
For the Applicant:
Suyi Cao, Applicant Peter Cimino, Counsel
For the Respondent:
Darryl McInnis, ADR Consultant
Robert Bowman, Counsel
Court Reporter:
Michelle Gordon
HEARD: by Videoconference:
May 13, 2024
OVERVIEW
1Suyi Cao, the applicant, was involved in an automobile accident on May 24, 2016, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (the “Schedule”). The applicant was denied benefits by the respondent, Insurer, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2A case conference was held by teleconference on October 17, 2023 which incorrectly stated that the dispute between the parties was under the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016). The matter was ordered to proceed to a five-day videoconference hearing which was scheduled to begin May 13, 2024.
PRELIMINARY ISSUES & Procedural matters
3The parties were directed at the outset of the hearing that prior to hearing evidence on the substantive issues in dispute I would be dealing with the following:
i. the respondent’s motion seeking to exclude an expert witness and their report;
ii. a detailed schedule of witnesses.
4In advance of hearing evidence, the parties were provided a brief recess for discussion. After a number of short breaks, the applicant advised the issues in dispute had been settled and the file at the Tribunal could be closed.
ISSUES
5The issues in dispute are:
i. Has the applicant sustained a catastrophic impairment as defined by the Schedule?
ii. Is the applicant entitled to an income replacement benefit in the amount of $400.00 per week from July 16, 2019 and ongoing?
iii. Is the applicant entitled to $2,572.06 for chiropractic services, proposed by Spinalcare in a treatment plan/OCF-18 dated November 28, 2018?
iv. Is the applicant entitled to $1,945.01 ($5,086.82 less $3,141.81 approved) for psychological services, proposed by Cliff Berish in a treatment plan/OCF-18 dated January 15, 2020?
v. Is the applicant entitled to $1,645.04 ($3,889.92 less $2,244.88 approved) for psychological services, proposed by Cliff Berish in a treatment plan/OCF-18 dated September 5, 2022?
vi. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT & ORDER
6The issues in dispute on this application were settled. The Tribunal’s file is closed.
Released: May 28, 2024
__________________________
Amar Mohammed
Adjudicator