Licence Appeal Tribunal File Number: 22-009392/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:
Alberto Granada
Applicant
and
Aviva General Insurance
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: Camilla Oblak, Counsel
HEARD: In Writing
OVERVIEW
1Alberto Granada, the applicant, was involved in an automobile accident on October 1, 2020, 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 General Insurance, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2In a case conference report and order released on May 17, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for February 16, 2024, with the Notice of Written Hearing e-mailed to the parties on May 26, 2023.
3The applicant’s initial submissions were due on January 17, 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 the initial submissions deadline.
4The respondent filed submissions with the Tribunal, seeking a dismissal of the application. The respondent is also seeking costs.
ISSUES
5As listed in the case conference report and order, the issues in dispute are:
i. Is the applicant entitled to $3,244.58 for physiotherapy services, proposed by Humber Civic Care Centre in a treatment plan/OCF-18 (“plan”) dated February 8, 2021?
ii. Is the applicant entitled to $2,629.85 for chiropractic services, proposed by Humber Civic Care Centre in a plan dated April 27, 2021?
iii. Is the applicant entitled to $112.81 ($2,322.27 less $2,209.26 approved) for physical therapy, proposed by Humber Civic Care Centre in a plan dated August 19, 2021?
iv. Is the applicant entitled to $448.83 ($4,960.48 less $4,511.65 approved) for psychological progress report, proposed by Humber Civic Care Centre in a plan dated September 15, 2021?
ANALYSIS
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 without submissions from the applicant.
7The applicant has the onus of demonstrating entitlement to the medical benefits 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 the initial submission deadline.
COSTS REQUEST
9Turning to the costs request, I do not find the respondent has met the threshold necessary for ordering costs.
10Rule 19.1 of the Licence Appeal Tribunal Rules, 2023 states that the Tribunal may award costs when “another party in a proceeding has acted unreasonably, frivolously, vexatiously, or in bad faith”. Rule 19.5 provides a list of factors the Tribunal shall consider when determining whether to order costs (and, if so, how much).
11The respondent supports its costs request by submitting that the applicant “acted unreasonably, frivolously, and/or in bad faith by bringing this application, refusing to comply with [the case conference report and order], and not serving and filing submissions and evidence”.
12I find the respondent has not established that the applicant’s behaviour merits a costs order. Though I recognize that the applicant breached the initial submissions deadline set out in the case conference report and order, I conclude that this breach is remedied through this present decision. As such, I find this case is not an appropriate matter to use the highly discretionary power afforded to the Tribunal under Rule 19.1.
ORDER
13As the applicant has made no submissions and tendered no evidence in support of the claims before the Tribunal, the applicant has not demonstrated entitlement to the medical benefits in dispute.
14The respondent’s cost request is denied.
15The application is dismissed.
Released: October 1, 2024
__________________________
Craig Mazerolle
Vice-Chair