Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 24-009809/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:
Qasim Enow
Applicant
and
Co-operators General Insurance Company
Respondent
DECISION
ADJUDICATOR:
Jeff Chatterton
APPEARANCES:
For the Applicant:
No Submissions
For the Respondent:
No Submissions
HEARD:
In Writing
OVERVIEW
1Qasim Enow, the applicant, was involved in an automobile accident on January 10, 2019, 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, Cooperators General Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
PRELIMINARY ISSUES
2The preliminary issues to be decided are:
i. Is the applicant barred from proceeding to a hearing for the following benefit(s): Issue 3 below for Psychological treatment because the applicant failed to dispute their denial within the 2-year limitation period?
ii. Is the applicant barred from proceeding to a hearing for the following benefit(s): Issue 4 below for Psychological treatment because the applicant failed to dispute their denial within the 2-year limitation period?
SUBSTANTIVE ISSUES
3The substantive issues in dispute are:
i. Is the applicant entitled to $1,014.37 ($1,646.06 less $631.69 approved) for Psychological treatment, proposed by Amena Psychology Professional Corporation in a treatment plan/OCF-18 (“plan”) dated August 10, 2022?
ii. Is the applicant entitled to $4,959.75 for Psychological treatment, proposed by Amena Psychology Professional Corporation in a plan dated August 9, 2022?
iii. Is the applicant entitled to $1,267.97 for Psychological treatment, proposed by Amena Psychology Professional Corporation in a plan dated June 8, 2022?
iv. Is the applicant entitled to $1,155.84 for Psychological treatment, proposed by Amena Psychology Professional Corporation in a plan dated February 5, 2022?
v. Is the applicant entitled to $2,200.00 for a Men’s Health Assessment, proposed by Quantum Health Men’s Clinic in a treatment plan dated October 7, 2022?
vi. Is the applicant entitled to $11,000.00 for Catastrophic Impairment Assessment, proposed by HAL Disability Management in a treatment plan dated December 7, 2022?
vii. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
viii. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
4The applicant is not entitled to the treatment plans, interest or award in dispute.
5The application is dismissed.
ANALYSIS
6In the case conference report and order released on January 10, 2025, the Tribunal ordered the issues in dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for September 12, 2025. Notice of the written hearing was e-mailed to the parties on January 28, 2025, using the contact information provided.
7The applicant’s counsel emailed the Tribunal on September 3, 2025, stating that counsel is experiencing a medical emergency, and that they would be forwarding submissions shortly and filing a motion requesting an adjournment.
8The Tribunal has not received any further communication from the applicant. No Notice of Motion has been filed with the Tribunal seeking to extend the applicant’s submission deadlines.
9The applicant’s initial submissions were due on August 13, 2025. No submissions were received.
10The respondent’s initial submissions were due August 28, 2025. No submissions were received.
11I find that the applicant had notice of the written hearing by way of e-mail on January 28, 2025 which was acknowledged by the applicant on September 3, 2025.
12Section 7(2) provides that where a notice of a written hearing has been given to a party to a proceeding in accordance with the SPPA and the party neither acts under clause 6(4)(b) no participates in the hearing in accordance with the notice, the tribunal may proceed without the party’s participation an the party is not entitled to any further notice in the proceeding.
13In this case, the applicant has not indicated that there is a good reason not to hold a hearing pursuant to s. 6(4) (b) and has not participated. I am satisfied I have the authority to continue with the hearing pursuant to s. 7(2) of the Statutory Powers Procedure Act (SPPA).
14The applicant has the onus of demonstrating that they are entitled to the medical treatments in dispute, as well as the award and interest.
15As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated that he is entitled to the medical treatments, an award or interest in dispute.
ORDER
16The applicant is not entitled to the treatment plans in dispute.
17As no benefits are owing, the applicant is not entitled to interest or an award.
18The application is dismissed.
Released: December 3, 2025
Jeff Chatterton
Adjudicator