Licence Appeal Tribunal File Number: 23-003648/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:
Nisha Seth
Applicant
and
Intact Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Kristen Ogden, Counsel
HEARD: By way of written submissions
OVERVIEW
1Nisha Seth, the applicant, was involved in an automobile accident on October 4, 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, Intact 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 November 23, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for July 5, 2024. Notice of this written hearing was e-mailed to the parties on November 30, 2023.
3The applicant’s initial submissions were due on June 5, 2024. The applicant has not filed any written submissions with the Tribunal, and there has been no motion made to extend the submission deadlines. The respondent filed its submissions on June 21, 2024.
4On June 26 and June 28, 2024, the Tribunal e-mailed the applicant indicating that no written submissions had been received. On July 29, 2024, the Tribunal e-mailed the applicant asking her to confirm if the file had been settled.
5No Notice of Withdrawal has been received by the Tribunal from the applicant.
ISSUES
6The 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 a non-earner benefit (“NEB”) of $185.00 per week from October 11, 2020 and ongoing?
iii. Is the applicant entitled to $3,795.50 for chiropractic services, proposed by Mackenzie Medical Rehabilitation Centre in a treatment plan/OCF-18 (“plan”) dated October 20, 2020?
iv. Is the applicant entitled to $2,026.55 for chiropractic services, proposed by Mackenzie Medical Rehabilitation in a plan dated February 22, 2021?
v. Is the applicant entitled to $1,417.70 for chiropractic services, proposed by Mackenzie Medical Rehabilitation Centre in a plan dated April 6, 2021?
vi. 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 written hearing.
8The applicant has the onus of demonstrating removal from the MIG. The applicant also has the onus of demonstrating entitlement to the NEB, treatment plans, and interest in dispute.
9As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not met the evidentiary burden to demonstrate entitlement to these substantive issues. I further find that no Notice of Motion has been filed seeking to extend the applicant’s submission deadlines.
ORDER
10As no submissions or evidence have been filed with the Tribunal by the applicant, I find that he applicant has not demonstrated removal from the MIG, nor has she demonstrated entitlement to a NEB, the treatment plans, and interest in dispute.
11The application is dismissed.
Released: February 14, 2025
__________________________
Tyler Moore
Vice-Chair