Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 23-009860/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:
Dayle Ayres
Applicant
and
TD General Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: John Lykos, Counsel
HEARD: By Way Of Written Submissions
OVERVIEW
1Dayle Ayres, the self-represented applicant, was involved in an automobile accident on May 30, 2017, 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, TD General Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2In the case conference report and order (“CCRO”) released on March 7, 2024, the Tribunal ordered the dispute to proceed to a written hearing. According to the CCRO, the applicant participated in the case conference. The Tribunal scheduled a written hearing for November 1, 2024. Notice of the written hearing was e-mailed to the parties and sent by regular mail to the applicant on March 21, 2024.
3The applicant’s initial submissions were due on October 2, 2024. The applicant has not filed any written submissions with the Tribunal to date, and there has been no motion to extend the submission deadlines.
4The respondent filed its written submissions on October 18, 2024.
5No further correspondence has been received from either party and the Tribunal has not received a Notice of Withdrawal.
ISSUES
6The issues in dispute are:
i. Has the applicant sustained a catastrophic impairment as defined by the Schedule?
ii. Is the applicant entitled to $3,192.23 for psychological services, proposed by Assurance Medical Services in a treatment plan/OCF-18 dated January 24, 2022?
iii. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
7Since the applicant did not file a Notice of Withdrawal with the Tribunal, the parties’ file was not closed, and I will proceed with the hearing pursuant to s. 7(2) of the Statutory Powers Procedure Act. I find that the applicant had notice of the written hearing.
8The applicant has the onus of demonstrating that a catastrophic impairment as defined by the Schedule was sustained, as well as entitlement to the medical benefit in dispute.
9As 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 a catastrophic impairment, nor entitlement to the medical benefit. I further find that no Notice of Motion has been filed seeking to extend the applicant’s submission deadlines.
ORDER
10As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated that a catastrophic impairment as defined by the Schedule was sustained, nor entitlement to the medical benefit and interest in dispute.
11The application is dismissed.
Released: May 5, 2025
__________________________
Tyler Moore
Vice-Chair