Licence Appeal Tribunal File Number: 20-000345/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:
Nuzhat Ibrahim
Applicant
and
Aviva Insurance Canada
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: Kimberley Tye, Counsel
HEARD: In Writing
OVERVIEW
1Nuzhat Ibrahim, the applicant, was involved in an automobile accident on January 12, 2018, 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, Aviva Insurance Canada, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2The applicant is deceased. According to the respondent, the applicant passed away in February 2020—shortly after this application was filed with the Tribunal.
ISSUES
3The issues in dispute are:
i. Is the applicant entitled to attendant care benefits of $9,012.31 per month from January 12, 2018 to December 17, 2018?
ii. Is the applicant entitled to attendant care benefits of $2,200.00 per month from December 18, 2018 to date and ongoing?
iii. Is the applicant entitled to $1,846.13 for chiropractic treatment recommended by Med Assess in a treatment plan (OCF-18) dated March 27, 2019?
iv. Is the applicant entitled to $933.27 for chiropractic treatment recommended by Med Assess in a treatment plan (OCF-18) dated March 27, 2019?
v. Is the applicant entitled to $3,518.06 for physical therapy recommended by Ortho Rehab Group in a treatment plan (OCF-18) dated March 27, 2019?
vi. Is the applicant entitled to $4,293.83 for physical therapy recommended by Movement Physio in a treatment plan (OCF-18) dated December 18, 2018?
vii. Is the applicant entitled to $1,649.29 for physical therapy recommended by Movement Physio in a treatment plan (OCF-18) dated December 11, 2018?
viii. Is the applicant entitled to $4,478.15 for physical therapy recommended by Movement Physio in a treatment plan (OCF-18) dated January 30, 2019?
ix. Is the respondent liable to pay an award under s. 10 of O. Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
x. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
4The applicant has the onus of demonstrating entitlement to the attendant care benefits, medical benefits, award, and interest in dispute.
5In a case conference report and order released on March 23, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for December 22, 2023. The applicant’s initial submissions were due on November 22, 2023. To date, no one has filed any written submissions with the Tribunal on behalf of the applicant, and there has been no motion made seeking to extend this deadline.
6The respondent filed submissions seeking a dismissal of the application. The respondent also provided an e-mail from a member of the applicant’s family (e-mail dated November 18, 2022). In this e-mail, the family member had forwarded the respondent a message from another individual who was holding themselves out as the “estate agent/trustee” of the applicant.
7I am satisfied that the case conference report and order (released March 23, 2023), as well as the Notice of Written Hearing, were both sent by the Tribunal to e-mail address provided by this family member on November 18, 2022. As such, I am, therefore, satisfied that information about when the applicant’s submissions were due was in the applicant’s family’s possession.
8As no submissions or evidence has been filed with the Tribunal by anyone on behalf of the applicant, I find that the applicant’s burden to demonstrate entitlement to the issues in dispute has not been met.
ORDER
9As the applicant has made no submissions and tendered no evidence in support of her claims, she has not demonstrated her entitlement to the attendant care benefits, medical benefits, award, and interest in dispute.
10The application is dismissed.
Released: August 8, 2024
Craig Mazerolle
Vice-Chair