Licence Appeal Tribunal File Number: 23-009884/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:
Leroy Wright
Applicant
and
Economical Mutual Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Yuliya Yarema, Paralegal
HEARD: By Way Of Written Submissions
OVERVIEW
1Leroy Wright, the applicant, was involved in an automobile accident on March 12, 2020, 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, Economical Mutual 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 released on April 17, 2024, the Tribunal ordered that the dispute proceed to a written hearing. The Tribunal scheduled a written hearing for November 29, 2024. Notice of the written hearing was e-mailed to the parties on April 11, 2024.
3The applicant's initial submissions were due on October 30, 2024. On October 31, 2024, the Tribunal e-mailed the parties as a reminder that the applicant's submissions had not been received. On November 7, 2024, the Tribunal e-mailed the parties again as a further reminder that the applicant's submissions had not been received.
4The respondent filed its written submissions on November 15, 2024.
5No further correspondence has been received from either party and the Tribunal has not received a Notice of Withdrawal.
ISSUES
6The preliminary issues in dispute are:
i. Is the applicant barred from proceeding to a hearing for all of the benefits claimed in this application because the applicant failed to dispute their denial within the 2-year limitation period?
ii. Is the applicant barred from proceeding to a hearing for all of the benefits claimed in this application because the applicant failed to attend an insurer's examination under s. 44 of the Schedule?
7The substantive 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 $2,000.00 for a chronic pain assessment, proposed by Normed Assessment Services in a treatment plan dated February 9, 2021?
iii. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
8Since 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.
9The applicant has the onus of demonstrating that he should be removed from the MIG and that he is entitled to a chronic pain assessment.
10As 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 that his injuries warrant removal from the MIG, and that he is entitled to a chronic pain assessment and interest. I further find that no Notice of Motion has been filed seeking to extend the applicant's submission deadlines.
11In light of these findings, I can then conclude that the preliminary issues are moot.
ORDER
12As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated that he should be removed from the MIG, and that he is entitled to the chronic pain assessment and interest in dispute.
13The preliminary issues are moot.
14The application is dismissed.
Released: May 22, 2025
Tyler Moore Vice-Chair