Licence Appeal Tribunal File Number: 23-001406/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:
Khawar Jamil
Applicant
and
Aviva Insurance Canada
Respondent
DECISION
VICE-CHAIR:
Tyler Moore
APPEARANCES:
For the Applicant:
Marc Golding, Paralegal (No submissions)
For the Respondent:
Kevin So, Counsel
HEARD:
By way of written submissions
OVERVIEW
1Khawar Jamil, the applicant, was involved in an automobile accident on January 29, 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 Insurance Canada, 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. 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 limit?
ii. Is the applicant entitled to an income replacement benefit (“IRB”) in the amount of $400.00 per week from February 5, 2021 to date and ongoing?
iii. Is the applicant entitled to $2,144.93 for a psychological assessment proposed by Chinguacousy Physiotherapy and Foot Clinic (“Chinguacousy”) in a treatment plan/OCF-18 (“plan”) that was submitted on August 27, 2021 and denied December 7, 2021?
iv. Is the applicant entitled to $3,460.88 for chiropractic treatment, proposed by Chinguacousy in a plan submitted on May 31, 2021 and denied June 10, 2021?
v. Is the applicant entitled to $2,503.22 for chiropractic treatment, proposed by Chinguacousy in a plan submitted on June 6, 2021 and denied on July 6, 2021?
vi. Is the applicant entitled to $1,215.32 for chiropractic treatment, proposed by Chinguacousy in a plan that was submitted on October 12, 2021 and denied on October 25, 2021?
vii. Is the applicant entitled to $1,215.32 for chiropractic treatment, proposed by Chinguacousy in a plan that was submitted on December 3, 2021?
viii. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3The applicant has the onus of demonstrating removal from the MIG. The applicant also has the onus of demonstrating entitlement to the medical benefits, IRB, and interest in dispute.
4Both parties attended the case conference, with their counsel. In the case conference report and order released on October 11, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for May 31, 2024. Notice of this written hearing was emailed to the parties on October 19, 2023, using the contact information they had provided.
5Both parties are represented by counsel or paralegal. The applicant’s initial written submissions were due on May 1, 2024 but none have been filed. The applicant did file medical records on January 3, 2024, but did not include any submissions. The respondent filed written submissions addressing the issues in dispute on May 15, 2024.
6Section 7(2) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 provides that where a Tribunal has given notice of a written hearing to a party to a proceeding and the party does not participate in the hearing in accordance with the notice, the Tribunal may proceed without the party’s participation and the party is not entitled to any further notice in the proceeding.
7There has been no motion made seeking to extend the initial submissions deadline by the applicant. I therefore proceeded with the hearing pursuant to s. 7(2) of the SPPA. As no submissions have been filed with the Tribunal by the applicant, I find that the applicant has not met his evidentiary burden.
ORDER
8As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated grounds for removal from the MIG, nor has he demonstrated entitlement to the medical benefits, IRB, and interest in dispute.
9The application is dismissed.
Released: January 14, 2025
__________________________
Tyler Moore
Vice-Chair