Hamalainen v. Aviva Insurance Canada, 2024 CanLII 81205

Licence Appeal Tribunal

Citation: Hamalainen v. Aviva Insurance Canada, 2024 ONLAT 21-009599/AABS

Licence Appeal Tribunal File Number: 21-009599/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:

Jani Hamalainen

Applicant

and

Aviva Insurance Canada

Respondent

DECISION

VICE-CHAIR: Craig Mazerolle

APPEARANCES:

For the Applicant: No submissions

For the Respondent: No submissions

HEARD: In Writing

OVERVIEW

1Jani Hamalainen, the applicant, was involved in an automobile accident on August 18, 2019, and sought benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”).

2The 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.

3In a case conference report and order (released October 4, 2022), the Tribunal ordered the parties’ dispute to proceed to a written hearing.

4By way of an amended Notice of Written Hearing sent out on October 14, 2022, the Tribunal scheduled a written hearing for August 25, 2023.

5The applicant’s initial submissions were due on July 26, 2023.

6Neither party filed written submissions in accordance with the deadlines set out in the case conference report and order, and neither party filed a Notice of Motion seeking to amend these deadlines.

ISSUES

7As listed in the case conference report and order, the issues in dispute are:

i. Is the applicant entitled to $848.75 for physiotherapy services, proposed by Physio DNA in a treatment plan/OCF-18 (‘plan’) dated June 7, 2021?

ii. Is the applicant entitled to $1,997.40 for a psychological assessment, proposed by Alliance Diagnostics and Treatments Inc. in a treatment plan dated December 4, 2019?

iii. Is the applicant entitled to $600.00 for other disputes, proposed by Alliance Diagnostics and Treatments Inc. in a plan dated December 11, 2019?

iv. 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?

v. Is the applicant entitled to interest on any overdue payment of benefits?

ANALYSIS

8The applicant has the onus of demonstrating 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 failed to meet this burden.

9I further find that the applicant did not file a Notice of Motion requesting an extension of the submissions deadlines.

ORDER

10As the applicant has made no submissions and tendered no evidence in support of this claim before the Tribunal, I find the applicant has not met the burden of demonstrating entitlement to the disputed medical benefits, award, and interest.

11The application is dismissed.