Licence Appeal Tribunal File Number: 23-006510/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:
Anadet Pyrrhon
Applicant
and
Economical Insurance Company
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: Pamela Vlasic, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Anadet Pyrrhon, the applicant, was involved in an automobile accident on January 11, 2021, and sought benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (“Schedule”). The applicant was denied benefits by the respondent, Economical Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (“Tribunal”) for resolution of the dispute.
2In a case conference report and order released on January 12, 2024, the Tribunal ordered the dispute to proceed to a written hearing.
3The Tribunal scheduled a written hearing for August 9, 2024, with the Notice of Written Hearing e-mailed to the parties on March 14, 2024. The applicant’s former (but then current) representative was included on this e-mail. The applicant was not included on this e-mail.
4On March 20, 2024, the applicant’s representative sent a Removal of Representative form to the Tribunal. This removal was confirmed by the Tribunal via e-mail on March 21, 2024.
5A subsequent Notice of Written Hearing was sent in error to the parties by e-mail on March 21, 2024. This second Notice of Written Hearing stated the written hearing was set for August 16, 2024. The applicant’s former representative was included on this e-mail. The applicant was not included on this e-mail.
6On May 31, 2024, Tribunal staff mailed the applicant a copy of the Notice of Written Hearing that indicated the written hearing was set for August 9, 2024.
7According to the initial Notice of Written Hearing, the applicant’s submissions were due on July 10, 2024. In accordance with the second Notice of Written Hearing that was sent in error (and never received by the applicant), the applicant’s submissions would have been due on July 17, 2024. The applicant did not provide submissions in accordance with either deadline.
8The respondent filed submissions with the Tribunal on July 26, 2024. The respondent states it had not received submissions from the applicant. It is seeking a dismissal of the applicant’s application.
9To date, the applicant has not provided any written submissions to the Tribunal. There has also been no Notice of Motion filed by the applicant seeking more time to file submissions.
ISSUES
10As listed in the case conference report and order, the issues in dispute are:
i. Are the applicant’s injuries predominantly minor as defined in section 3 of the Schedule and therefore subject to treatment within the $3,500.00 Minor Injury Guideline limit?
ii. Is the applicant entitled to $2,200.00 for a chronic pain assessment, proposed by Novo Medical Services in a treatment plan/OCF-18 (‘plan’) dated January 10, 2022?
iii. Is the applicant entitled to $1,950.75 for physiotherapy services, proposed by East York Physiotherapy in a treatment plan/OCF-18 (‘plan’) dated June 29, 2022?
iv. Is the applicant entitled to $2,200.00 for a psychological assessment, proposed by East York Physiotherapy in a treatment plan/OCF-18 (‘plan’) dated April 21, 2023?
v. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
vi. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
11Section 7(2) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22 states that, if notice of a written hearing has been given to a party who does not then participate in the hearing in accordance with the notice, the Tribunal may proceed with the hearing in the absence of that party’s participation.
12Since the initial Notice of Written Hearing was mailed to the applicant on May 31, 2024, I am satisfied that the applicant received notice of the August 9, 2024 written hearing date. I shall proceed without submissions from the applicant.
13The applicant has the onus of demonstrating removal from the Minor Injury Guideline, as well as entitlement to the disputed medical benefits, award, and interest. By not filing any submissions or evidence with the Tribunal, I find that the applicant has not met this burden.
14I further find that the applicant has not filed a Notice of Motion requesting more time to file submissions.
ORDER
15As the applicant has made no submissions and tendered no evidence in support of the claims before the Tribunal, the applicant has not demonstrated removal from the Minor Injury Guideline, nor has the applicant demonstrated entitlement to the disputed medical benefits, award, and interest.
16The application is dismissed.
Released: March 14, 2025
Craig Mazerolle
Vice-Chair