Licence Appeal Tribunal File Number: 24-005964/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:
Leroy Wright
Applicant
and
Definity Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Yuliya Yarema, Paralegal
HEARD: By Way of Written Submissions
OVERVIEW
1Leroy Wright, the applicant, was involved in an automobile accident on March 12, 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, Definity Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the "Tribunal") for resolution of the dispute.
ISSUES
2The preliminary issue in dispute is:
i. Is the applicant barred from proceeding to a hearing for all of the benefits claimed in this application because the applicant failed to attend an insurer's examination under s. 44 of the Schedule?
3The substantive 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 $2,050.00 for a social work assessment, proposed by East Sheppard Assessment Services in a treatment plan/OCF-18 ("plan") submitted April 17, 2024?
iii. Is the respondent liable to pay an award under s. 10 of 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
4In the case conference report and order released on September 24, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for June 13, 2025. Notice of the written hearing was e-mailed to the parties on October 3, 2024.
5On May 16, 2025, the Tribunal e-mailed the parties asking them to advise if the matter had resolved, and if so to file a Notice of Withdrawal, because the applicant's initial submissions had not been received. A copy of the case conference report and order was included.
6On July 10, 2025, the Tribunal e-mailed the parties again after the applicant's submissions had still not been received.
7The applicant's initial submissions were due on May 14, 2025.
8The respondent filed its written submissions on May 30, 2025.
9The Tribunal has not received any further correspondence from the applicant, and no Notice of Withdrawal has been filed. I further find that no Notice of Motion has been filed seeking to extend the applicant's submission deadlines.
10Since the applicant did not file a Notice of Withdrawal with the Tribunal, the parties' file was not closed, and I will proceed with the hearing pursuant to s. 7(2) of the Statutory Powers Procedure Act. I find that the applicant had notice of the written hearing by e-mail on October 3, 2024.
11The applicant has the onus of demonstrating that he should be removed from the MIG, and that he is entitled to the medical benefit and award in dispute.
12As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated that he should be removed from the MIG, and that he is entitled to the medical benefit, award, and interest in dispute.
ORDER
13The applicant remains in the MIG and is not entitled to the treatment plan in dispute.
14As no benefits are owing, the applicant is not entitled to interest or an award.
15The application is dismissed.
Released: October 8, 2025
Tyler Moore
Vice-Chair