Valladares v. Allstate Insurance Company of Canada
Licence Appeal Tribunal File Number: 22-003423/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:
Andrea Valladares
Applicant
and
Allstate Insurance Company of Canada
Respondent
DECISION
ADJUDICATOR: Timothy Porter
APPEARANCES:
For the Applicant: Andrea Valladares, Applicant Shen Subramaniam, Counsel Vladislav Lynsaght, Counsel
For the Respondent: Sam Davies, Counsel
HEARD: In Writing
OVERVIEW
1Andrea Valadares, the applicant, was involved in an automobile accident on October 6, 2013, and sought benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (“Schedule”). The applicant was denied benefits by the respondent, Allstate Insurance Company of Canada, and applied to the Licence Appeal Tribunal – Automobile Accident Benefits Service (“Tribunal”) for resolution of the dispute.
ISSUES
2The 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 (“MIG”) limit?
ii. Is the applicant entitled to $1,995.33 for a psychological assessment, proposed by Midland Wellness Centre in a treatment plan denied on March 8, 2022?
iii. Is the applicant entitled to $2,164.00 for a chronic pain assessment, proposed by Midland Wellness Centre in a treatment plan denied on March 8, 2022?
iv. Is the applicant entitled to interest on any overdue payment of benefits?
v. Is the respondent liable to pay an award under s.10 of o. Reg. 664 because if unreasonably withheld or delayed payments to the applicant?