1Muhssun Hussun, the applicant, was involved in an automobile accident on November 19, 2021, 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 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 May 4, 2022 and ongoing?

ii. Is the applicant entitled to the assessments and treatments proposed by Princeton Hills Medical Assessments, as follows:

i. $2,410.00 for an orthopaedic surgery assessment, in a treatment plan submitted June 9, 2023;

ii. $2,670.00 for a neurological assessment, in a treatment plan submitted June 9, 2023; and

iii. $1,870.20 ($5,815.13 less $3,944.93 approved) for psychological services, in a treatment plan submitted August 10, 2023?

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?

RESULT

3I find that the applicant is not entitled to a NEB of $185.00 per week from May 4, 2022 and ongoing.

4I find that the applicant is not entitled to the treatment plans for an orthopedic surgery assessment or a neurological assessment.