Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 24-011215/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:
Andre Rambarran
Applicant
and
Certas Home and Auto Insurance Company
Respondent
DECISION
ADJUDICATOR: Nishant Nayak
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Tripta Sood, Counsel
HEARD: By way of written submissions
OVERVIEW
1Andre Rambarran, the applicant, was involved in an automobile accident on July 12, 2022, 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, Certas Home and Auto Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the "Tribunal") for resolution of the dispute.
2In the case conference report and order released on January 13, 2025, and later amended case conference report and order released on January 21, 2025, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for August 29, 2025. Notice of the written hearing was e-mailed to the parties on January 21, 2025.
3The applicant's initial written submissions were due on July 30, 2025. On August 8, 2025, the Tribunal reached out to the applicant by e-mail to advise that no submissions had been received. The applicant has not filed any written submissions with the Tribunal to date, and there has been no motion made to extend the submission deadlines.
4The respondent filed its written submissions on August 20, 2025.
5The Tribunal has not received the Notice of Withdrawal form to date from the applicant.
ISSUES
6The issues in dispute are:
I. Is the applicant entitled to $44.00 ($1,525.84 less $1,481.84 approved) for Chiropractic treatment, proposed by Mackenzie Medical Rehabilitation Centre in a treatment plan/OCF-18 ("plan") dated June 1, 2023?
II. Is the applicant entitled to $726.00 ($4,230.93 less $3,504.93 approved) for Occupational Therapy treatment, proposed by FunctionAbility Rehabilitation Services in a plan dated April 18, 2023?
III. Is the applicant entitled to $44.00 ($1,857.30 less $1,802.30 approved) for Chiropractic treatment, proposed by Mackenzie Medical Rehabilitation Centre in a plan dated April 20, 2023?
IV. Is the applicant entitled to $66.00 ($2,188.76 less $2,122.76 approved) for Chiropractic treatment, proposed by Mackenzie Medical Rehabilitation Centre in a plan dated March 9, 2023?
V. Is the applicant entitled to $77.00 ($2,520.22 less $2,433.22 approved) for Chiropractic treatment, proposed by Mackenzie Medical Rehabilitation Centre in a plan dated January 19, 2023?
VI. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
VII. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
7Since 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.
8The applicant has the onus of demonstrating that he is entitled to the medical benefits and award in dispute.
9As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated entitlement to the medical benefits, award, and interest in dispute. I further find that no Notice of Motion has been filed seeking to extend the applicant's submission deadline.
ORDER
10The applicant is not entitled to the treatment plans in dispute.
11As not benefits are owing, the applicant is not entitled to interest or an award.
12The application is dismissed.
Released: October 22, 2025
Nishant Nayak Adjudicator