Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 22-008623/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:
Ali Bagherian
Applicant
and
Aviva Insurance Company of Canada
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: Suzanne Clarke, Counsel
HEARD: In Writing
OVERVIEW
1Ali Bagherian, the applicant, was involved in an automobile accident on February 18, 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, Aviva Insurance Company of Canada, 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 April 12, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for January 19, 2024, with the Notice of Written Hearing e-mailed to the parties on May 10, 2023.
3The applicant’s initial submissions were due on December 20, 2023. The applicant has not provided 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 applicant has e-mailed the Tribunal several times asking for a reconsideration of the April 12, 2023 case conference report and order. The applicant has not made these requests via a reconsideration request form, so I have decided not to consider his reconsideration requests, pursuant to Rule 18.1 of the Common Rules of Practice and Procedure.
5The respondent filed submissions with the Tribunal, seeking a dismissal of the application. It is also seeking costs.
ISSUES
6As listed in the case conference report and order, the issues in dispute are:
i. Is the applicant entitled to $6,748.00 for dental services, proposed by Dr. Nourkeyhani in a treatment plan/OCF-18 dated January 20, 2020?
ii. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
7Section 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.
8The applicant has the onus of demonstrating entitlement to the medical benefit and interest in dispute. By not filing any submissions or evidence with the Tribunal, I find that the applicant has not met this burden.
9I further find that the applicant did not file a Notice of Motion requesting an extension of the initial submission deadline.
COSTS REQUEST
10Turning to the costs request, I do not find the respondent has met the high threshold necessary for ordering costs.
11Rule 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).
12The respondent supports its request by submitting that the applicant “knew, or ought to have known, that [the respondent] would incur costs and spend time defending the claims against it that it could have otherwise spent on other proceedings.” The respondent also highlights the applicant’s breach of the deadlines for productions and submissions set out in the case conference report and order.
13I find the respondent has not established that the applicant’s behaviour merits a costs order. Though I recognize that the applicant has breached the submissions deadline from the case conference report and order (a breach that has prejudiced the respondent and impacted the Tribunal’s ability to carry out a fair, efficient, and effective process), I conclude that his breach is remedied through this decision. As such, I do not find a costs order is needed.
ORDER
14As the applicant has made no submissions and tendered no evidence in support of his claims before the Tribunal, he has not demonstrated entitlement to the disputed medical benefit and interest.
15The respondent’s request for costs is denied.
16The application is dismissed.
Released: October 10, 2024
Craig Mazerolle
Vice-Chair