Licence Appeal Tribunal File Number: 24-001739/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:
Diane Holder
Applicant
and
Economical Mutual Insurance Company
Respondent
DECISION
ADJUDICATOR: Timothy Porter
APPEARANCES:
For the Applicant: Diana Holder, Self-represented (Did not attend)
For the Respondent: Domenic Nicassio, Counsel
Heard by Videoconference: February 3, 2025
OVERVIEW
1Diana Holder, the applicant, was involved in an automobile accident on December 22, 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, Economical Mutual Insurance Company, and applied to the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2The self-represented applicant did not attend the hearing. A brief summary of events leading up to the hearing is set out below:
i. The applicant attended the case conference on June 28, 2024. She was represented by counsel at that time. The matter was set down for a 7-day videoconference hearing, scheduled to start on February 3, 2025.
ii. The Notice of Hearing was sent on July 19, 2024, to the parties, including the applicant and her counsel of record.
iii. The applicant’s representative of record provided notice to the Tribunal that they were removing themselves on December 30, 2024.
iv. On January 13, 2025, the respondent served the applicant with their document brief.
v. On January 20, 2025, the Tribunal reached out to the applicant (and respondent) via email to request a hearing status update, along with a subsequent email that specifically requests that the applicant to reply. No reply was received.
vi. At the beginning of the hearing on February 3, 2025, at 9:30 AM, the applicant was not in attendance. I ordered, a 30-minute recess so that the Tribunal could attempt to reach the applicant. The Tribunal’s Case Management Officer (CMO) placed a phone call to the applicant, but the call went straight to voicemail. Of note, respondent’s counsel submitted that the respondent had made two attempts by email (January 2 and 7, 2025) and two attempts by couriered letter (January 8 and 15, 2025) to communicate with the applicant and had received no response.
vii. As I was satisfied that the applicant had proper notice of the date and time for the hearing, I proceeded with the scheduled hearing at 10:05 AM.
ISSUES
3The issues in dispute are:
i. Has the applicant sustained a catastrophic impairment as defined by the Schedule?
ii. Is the applicant entitled to a non-earner benefit of $185.00 per week from December 22, 2020, to December 22, 2022?
iii. Is the applicant entitled to $760.00 for chiropractic services, proposed by Lawrence Chiropractic Professional Corporation in a treatment plan/OCF-18 (“plan”) dated August 30, 2023?
iv. Is the applicant entitled to $5,505.72 for speech language pathology services, proposed by FunctionAbility Rehabilitation Services in a treatment plan dated October 13, 2022?
v. Is the applicant entitled to $5,765.56 for occupational therapy services, proposed by FunctionAbility Rehabilitation Services in a treatment plan dated September 8, 2022?
vi. Is the applicant entitled to $1,465.89 for occupational therapy services, proposed by FunctionAbility Rehabilitation Services in a treatment plan dated September 1, 2021?
vii. Is the applicant entitled to $8,791.40 ($16,272.00 less $7,480.60 approved) for a catastrophic impairment assessment, proposed by CVF Inc., in a treatment plan dated September 14, 2022?
viii. Is the applicant entitled to $350.43 for transportation expenses, submitted on a claim form (OCF-6) dated December 20, 2022?
ix. Is the applicant entitled to attendant care benefits in the amount of $1,506.99 per month from December 22, 2020, to date and ongoing?
x. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
xi. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
4As the applicant has made no submissions and tendered no evidence in support of her claims before the Tribunal, the applicant has not met her onus to prove entitlement to the benefits claimed.
5The application is dismissed.
ANALYSIS
6Section 7(3) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 (“SPPA”) states that, if notice of an oral hearing has been given to a party to a proceeding in accordance with the SPPA and the party does not attend at the hearing, the tribunal may proceed in the absence of the party and the party is not entitled to any further notice of the proceeding.
7As noted above, I am satisfied that the applicant was given notice of the videoconference hearing on July 19, 2024.
8The Tribunal also attempted to contact the applicant on January 20, 2025, by email about the hearing. Pursuant to the Licence Appeal Tribunal Rules, 2023 (“Rules”) Rule 4.4, an applicant is required to notify the Tribunal promptly of any change in contact information.
9Rules 3.7 and 3.7.1 require the applicant to attend the hearing and for the Tribunal to wait 30 minutes from the scheduled start of the hearing. Therefore, after being satisfied that the applicant was provided with notice of the hearing and after waiting for 30 minutes during which time the CMO tried unsuccessfully to contact the applicant, I proceeded with the hearing in the applicant’s absence.
10After hearing submissions from the respondent and entering their evidence into the record, approximately one hour had passed from the start of the hearing. The applicant did not attend.
11I find that the applicant has not met her onus of demonstrating that she is entitled to the benefits in dispute. By not attending the hearing and not providing any submissions or evidence, I find that the applicant has not met her burden.
12As the applicant made no submissions and tendered no evidence, I find that the applicant is not entitled to the benefits claimed.
ORDER
13As the applicant has made no submissions and tendered no evidence in support of her claims before the Tribunal, the applicant has not met her onus to prove entitlement to the benefits claimed.
14The application is dismissed.
Released: March 6, 2025
Timothy Porter Adjudicator