Licence Appeal Tribunal File Number: 22-008918/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:
Adeil Chomo
Applicant
and
Co-operators General Insurance Company
Respondent
DECISION
VICE-CHAIR:
Craig Mazerolle
APPEARANCES:
For the Applicant:
No submissions
For the Respondent:
Amanda Lennox, Counsel
HEARD: In Writing
OVERVIEW
1Adeil Chomo, the applicant, was involved in an automobile accident on October 26, 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, Co-operators General Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the "Tribunal") for resolution of the dispute.
ISSUES
3As listed in the case conference report and order, the 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 a non-earner benefit of $185.00 per week from August 20, 2021 to October 26, 2021?
iii. Is the applicant entitled to $1,320.00 for chiropractic services recommended by Oxford Spine Center, denied June 25, 2021?
iv. Is the applicant entitled to $1,544.00 for chiropractic services recommended by Oxford Spine Center, denied February 12, 2020?
v. Is the applicant entitled to $3,070.22 for an orthopaedic assessment, denied September 12, 2022?
vi. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
4The applicant has the onus of demonstrating removal from the MIG, as well as entitlement to the non-earner benefit, medical benefits and interest in dispute.
5In a case conference report and order (released April 27, 2023), the Tribunal ordered the dispute to proceed to a written hearing. By way of a Notice of Written Hearing sent out on May 11, 2023, the Tribunal scheduled a written hearing for February 2, 2024.
6The applicant's initial submissions were due on January 3, 2024. The applicant did not file written submissions in accordance with the deadlines set out in the case conference report and order.
7The respondent filed submissions seeking a dismissal of the applicant's application.
8I do note that the applicant is self-represented. The motion order removing the applicant's prior representative was released on May 11, 2023. Following the release of this order, Tribunal staff mailed the applicant about the representative on October 3, 2023 (the preferred method of communication as marked on the applicant's application). Then, on February 27, 2024, Tribunal staff e-mailed the applicant a copy of the case conference report and order, a copy of the May 11, 2023 motion order, and a copy of the May 11, 2023 Notice of Written Hearing. Despite this communication, the applicant did not file a Notice of Motion with the Tribunal seeking to remedy the lack of written hearing submissions.
9By not filing any submissions or evidence with the Tribunal, I find that the applicant has failed to meet the evidentiary burden needed to demonstrate removal from the MIG, nor has the applicant demonstrated entitlement to the non-earner benefit, medical benefits and interest in dispute. I further find that, despite efforts from the Tribunal to try and communicate on several occasions, the applicant did not file a Notice of Motion requesting an extension of the initial submissions deadline.
ORDER
10As the applicant has made no submissions and tendered no evidence in support of this claim, I find the applicant has not met the burden of demonstrating removal from the MIG, nor has the applicant demonstrated entitlement to the non-earner benefit, medical benefits, and interest in dispute.
11The application is dismissed.
Released: September 26, 2024
Craig Mazerolle
Vice-Chair