Licence Appeal Tribunal File Number: 23-008970/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:
Alexander Ermonik
Applicant
and
Belair Insurance Company Inc.
Respondent
DECISION
VICE-CHAIR:
Tyler Moore
APPEARANCES:
For the Applicant:
No Submissions
For the Respondent:
No Submissions
HEARD:
By way of written submission
OVERVIEW
1Alexander Ermonik, the applicant, was involved in an automobile accident on January 2, 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, Belair Insurance Company Inc., 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 (“MIG”) limit?
ii. Is the applicant entitled to $3,002.35 for physiotherapy services, proposed by HM Medical Network Inc., in a treatment plan/OCF-18 (“plan”) dated January 10, 2022?
iii. Is the applicant entitled to the assessments proposed by HM Medical Network Inc., as follows:
a) $2,460.00 for a psychological assessment, in a plan dated June 14, 2022; and
b) $2,979.80 for a chronic pain assessment, in a plan dated December 20, 2022?
iv. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
v. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3Both parties attended the case conference, with their counsel. In the case conference report and order released on February 6, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for September 20, 2024. Notice of this written hearing was emailed to the parties on February 8, 2024, using the contact information they had provided.
4The applicant’s initial written submissions were due on August 21, 2024.
5Since 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.
6The applicant has the onus of demonstrating removal from the MIG. The applicant also has the onus of demonstrating entitlement to the medical benefits, interest, and award in dispute.
7Neither party has filed submissions. There has been no motion made seeking to extend the submission deadline, and no Notice of Withdrawal has been received from the applicant.
8As 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.
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, interest, and award in dispute.
10The applicant is dismissed.
Released: March 14, 2025
Tyler Moore
Vice-Chair