Licence Appeal Tribunal File Number: 22-008867/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:
Ahmed Alam
Applicant
and
Certas Home and Auto
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: Stephanie Charikar, Counsel
HEARD: In Writing
OVERVIEW
1Ahmed Alam, the applicant, was involved in an automobile accident on August 14, 2017, 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 Home and Auto, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “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 $3,487.03 for physiotherapy services, proposed by HM Medical Network Ltd. in a treatment plan dated June 27, 2022?
iii. Is the applicant entitled to $2,663.40 for a Chronic Pain Assessment, proposed by HM Medical Network Ltd. in a treatment plan dated July 21, 2022?
iv. Is the respondent liable to pay an award under s. 10 of 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
3In a case conference report and order released on May 9, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for February 9, 2024, with the notice of written hearing e-mailed to the parties on May 18, 2023.
4The applicant’s initial submissions were due on January 10, 2024. The applicant has not provided any written submissions to the Tribunal. There has also been no Notice of Motion filed by the applicant seeking to extend his initial submissions deadline.
5The respondent filed submissions with the Tribunal, seeking a dismissal of the application. The respondent also filed two Notices of Motion seeking both a dismissal of the award claim (signed December 29, 2023), as well as an order striking an expert report from the applicant (signed January 9, 2024).
6Section 7(2) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 states that, if notice of a written hearing has been given to a party who does not then participate in the hearing in accordance with the notice, the Tribunal may proceed with the hearing in the absence of that party’s participation. I am satisfied that the parties received notice of the written hearing, so I shall proceed in the applicant’s absence.
7The applicant has the onus of demonstrating removal from the MIG, as well as 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 not met this burden.
8I further find that the applicant did not file a Notice of Motion requesting an extension of his initial submissions deadline.
9Finally, as I have found the applicant has not met the evidentiary onus to demonstrate removal from the MIG, nor has he demonstrated entitlement to the medical benefits, award, and interest in dispute, I find the respondent’s two motions are now moot.
ORDER
10As the applicant has made no submissions and tendered no evidence in support of his claims before the Tribunal, he has not demonstrated removal from the MIG, nor has he demonstrated entitlement to the medical benefits, award, and interest in dispute.
11The respondent’s Notices of Motion (signed December 29, 2023 and January 9, 2024) are dismissed.
12The application is dismissed.
Released: September 23, 2024
Craig Mazerolle
Vice-Chair