Licence Appeal Tribunal File Number: 21-010207/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:
Brian Chariton
Applicant
and
Certas Direct Insurance Company
Respondent
DECISION
VICE-CHAIR:
Craig Mazerolle
APPEARANCES:
For the Applicant:
No submissions
For the Respondent:
Catherine H Zingg, Counsel
Written Hearing:
Heard by way of written submissions
OVERVIEW
1Brian Chariton, the applicant, was involved in an automobile accident on December 21, 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, Certas Direct Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2The applicant passed away in February 2023. According to the case conference report and order released on April 14, 2023, an “estate trustee is yet to be appointed”. Since then, the Tribunal has not been provided with any documentation to show that an estate trustee has been appointed.
ISSUES
3The issues in dispute are:
i. Is the applicant entitled to an income replacement benefit in the amount of $400.00 per week from October 20, 2020 to February 12, 2023?
ii. Is the applicant entitled to $421.44 for physical treatment, proposed by Aqua Wellness Centre Ltd. in a treatment plan/OCF-18 (“plan”) dated December 16, 2019?
iii. Is the applicant entitled to $2,183.00 for chiropractic services, proposed by Aqua Wellness Centre Ltd. in a treatment plan dated December 17, 2019?
iv. Is the applicant entitled to $2,115.00 for chiropractic services, proposed by Aqua Wellness Centre Ltd. in a treatment plan dated February 21, 2020?
v. Is the applicant entitled to $1,969.80 for chiropractic services, proposed by Aqua Wellness Centre Ltd. in a treatment plan dated September 11, 2020?
vi. Is the applicant entitled to $1,811.90 for physical treatment, proposed by Aqua Wellness Centre Ltd. in a treatment plan dated November 17, 2020?
vii. Is the applicant entitled to $1,699.10 for physical treatment, proposed by Aqua Wellness Centre Ltd. in a treatment plan dated July 6, 2021?
viii. Is the applicant entitled to $2,200.00 for a Chronic Pain Assessment, proposed by Community Health and Counselling Service in a treatment plan dated January 25, 2020?
ix. Is the applicant entitled to the assessments proposed by Aqua Wellness Centre Ltd., as follows:
i. $2,200.00 for an In Home Assessment, in a treatment plan dated August 20, 2019; and
ii. $2,200.00 for a Psychology Assessment, in a treatment plan dated October 29, 2019?
x. 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?
xi. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
4The applicant has the onus of demonstrating entitlement to the income replacement benefit, medical benefits, award, and interest in dispute.
5In the case conference report and order, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for January 19, 2024. Notice of this written hearing was e-mailed to the parties on May 19, 2023.
6The applicant’s initial submissions were due on December 20, 2023. 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.
7The respondent filed submissions seeking a dismissal of the application.
8As no submissions or evidence have been filed with the Tribunal on behalf of the applicant, I find that the applicant’s burden to demonstrate entitlement to the issues in dispute has not been met. I further find that no Notice of Motion has been filed seeking to extend the initial submissions deadline.
ORDER
9As no submissions or evidence have been filed with the Tribunal on behalf of the applicant, I find that the applicant’s burden to demonstrate entitlement to the income replacement benefit, medical benefits, award, and interest in dispute has not been met.
10The application is dismissed.
Released: September 26, 2024
__________________________
Craig Mazerolle
Vice-Chair