Licence Appeal Tribunal File Number: 24-007146/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:
Mercedes Ricardo Lopes
Applicant
and
The Dominion of Canada General Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: No Submissions
HEARD: By Way of Written Submissions
OVERVIEW
1Mercedes Ricardo Lopes, the applicant, was involved in an automobile accident on November 4, 2023, 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, The Dominion of Canada General Insurance Company, 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. Is the applicant entitled to a non-earner benefit of $185.00 per week from December 2, 2023 to date and ongoing?
ii. Is the applicant entitled to attendant care benefits in the amount of $3,016.90 per month from March 23, 2024 to ongoing?
iii. Is the applicant entitled to $2,686.00 for a neurology evaluation, proposed by 101 Assessments in a treatment plan/OCF-18 (“plan”) dated May 7, 2024?
iv. Is the applicant entitled to $598.44 ($6,502.70 less $5,904.26 approved) for psychological services, proposed by 101 Assessments in a plan dated February 21, 2024?
v. Is the applicant entitled to $2,170.35 for assistive devices, proposed by 101 Assessments dated April 2, 2024?
vi. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3In the case conference report and order released on October 21, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for July 4, 2025. Notice of the written hearing was e-mailed to the parties on October 29, 2024, using the contact information provided.
4The applicant’s initial submissions were due on June 4, 2025.
5The respondent’s written submissions were due on June 20, 2025.
6On August 3, 2025, the Tribunal e-mailed the parties to advise that no hearing submissions had been received. The Tribunal attached a copy of the case conference report and order as well as the Notice of Written Hearing.
7The Tribunal has not received any further correspondence from the parties. The applicant has not filed a Notice of Withdrawal with the Tribunal, and I find that no Notice of Motion has been filed seeking to extend the submission deadlines.
8Since the applicant did not file a Notice of Withdrawal, 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 29, 2024 and August 3, 2025.
9The applicant has the onus of demonstrating entitlement to a non-earner benefit, attendant care benefits, and the medical benefits in dispute.
10As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated entitlement to the non-earner benefit, attendant care benefits, medical benefits, and interest in dispute.
ORDER
11The applicant is not entitled to a non-earner benefit or attendant care benefits in the amount of $3,016.90 per month from March 23, 2024 to date and ongoing.
12The applicant is not entitled to the treatment plans in dispute.
13As no benefits are owing, the applicant is not entitled to interest.
14The application is dismissed.
Released: October 10, 2025
Tyler Moore Vice-Chair