Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 22-010458/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:
Sanjay Kumar
Applicant
and
Aviva General Insurance
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: No submissions
HEARD: In Writing
OVERVIEW
1Sanjay Kumar, the applicant, was involved in an automobile accident on September 26, 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, Aviva General Insurance, 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 $2,606.90 for chronic pain assessment, proposed by Dr. Kevin Rod in a treatment plan/OCF-18 submitted on September 12, 2022, and denied on September 16, 2022?
iii. 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?
iv. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3The applicant has the onus of demonstrating removal from the MIG. The applicant also has the onus of demonstrating entitlement to the medical benefit, award, and interest in dispute.
4In the case conference report and order released on May 10, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for February 9, 2024. Notice of this written hearing was e-mailed to the parties on May 15, 2023.
5The applicant's initial written submissions were due on January 10, 2024. The applicant has not filed any written submissions, and there has been no motion made seeking to extend the applicant's initial submissions deadline.
6The respondent filed a Notice of Motion (dated March 8, 2024) seeking to dismiss the application as abandoned.
7As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not met the evidentiary burden. I further find that no Notice of Motion has been filed seeking to extend the applicant's initial submissions deadline.
8In light of this finding, I can then conclude that the respondent's Notice of Motion is moot.
ORDER
9As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated removal from the MIG, nor has the applicant demonstrated entitlement to the medical benefit, award, and interest in dispute.
10The respondent's Notice of Motion (dated March 8, 2024) is dismissed.
11The application is dismissed.
Released: October 9, 2024
Craig Mazerolle
Vice-Chair