Licence Appeal Tribunal File Number: 23-007869/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:
Gejza Bagar
Applicant
and
Jevco Insurance Company
Respondent
DECISION
VICE-CHAIR:
Tyler Moore
APPEARANCES:
For the Applicant:
No Submissions
For the Respondent:
Robbie Brar, Counsel
HEARD:
By Way of Written Submissions
OVERVIEW
1Gejza Bagar, the applicant, was involved in an automobile accident on April 12, 2022, 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, Jevco Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2In the Motion Order released on August 2, 2024, the Tribunal ordered the conversion of the dispute from a videoconference hearing to a written hearing. The Tribunal scheduled a written hearing for September 22, 2024. Notice of this written hearing was e-mailed to the parties on August 15, 2024.
3The applicant’s submissions were due on August 23, 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 September 6, 2024.
4No Notice of Withdrawal has been received by the Tribunal from the applicant.
ISSUES
5The 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 (“MIG”)?
ii. Is the applicant entitled to medical benefits and cost of examination expenses, proposed by East Rehabilitation Centre in the following treatment plans/OCF-18s (“plans”)?
a. $2,681.82 for physiotherapy submitted March 9, 2023;
b. $3,731.28 for physiotherapy submitted July 28, 2022; and
c. $1,998.50 for a functional abilities evaluation submitted September 18, 2022?
iii. Is the applicant entitled to $2,983.20 for a psychological assessment, proposed by Paramount Medical Assessments in a plan submitted August 11, 2022?
iv. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
6Since 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 pursuant to s. 7(2) of the Statutory Powers Procedure Act. I find that the applicant had notice of the written hearing.
7The applicant has the onus of demonstrating removal from the MIG. The applicant also has the onus of demonstrating entitlement to the medical benefits and interest in dispute.
8As no submissions 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
9As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated removal from the MIG, nor has he demonstrated entitlement to the medical benefits, and interest in dispute.
10The application is dismissed.
Released: March 19, 2025
Tyler Moore
Vice-Chair