Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 23-004252/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:
Nazar Petros
Applicant
and
Wawanesa Insurance
Respondent
DECISION
VICE-CHAIR: Craig Mazerolle
APPEARANCES:
For the Applicant: No submissions
For the Respondent: Nigel Crowe, Counsel
HEARD: By way of Written Submissions
OVERVIEW
1Nazar Petros, the applicant, was involved in an automobile accident on April 17, 2018, 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, Wawanesa Insurance, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
2In a case conference report and order released on December 12, 2023, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for July 19, 2024, with the Notice of Written Hearing e-mailed to the parties on December 14, 2023.
3The applicant’s initial submissions were due on June 19, 2024. The applicant has not provided written submissions to the Tribunal. There has also been no Notice of Motion filed by the applicant seeking to extend the initial submissions deadline.
4The respondent filed submissions with the Tribunal, seeking a dismissal of the application. It is also seeking costs in the amount of $1,000.00.
ISSUES
5As 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 (“MIG”) limit?
ii. Is the applicant entitled to $2,821.60 for psychological services, proposed by HM Medical Network Ltd. in a treatment plan/OCF-18 (“plan”) submitted November 12, 2021, and denied November 23, 2021?
iii. Is the applicant entitled to $2,460.00 for a chronic pain assessment, proposed by HM Medical Network Ltd. in a plan submitted October 28, 2021, and denied November 11, 2021?
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
6Section 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. I am satisfied that the parties received notice of the written hearing, so I shall proceed in the applicant’s absence.
7The applicant has the onus of establishing removal from the MIG, as well as entitlement to the medical benefits, award, and interest in dispute. By not filing any submissions or evidence with the Tribunal, I find that the applicant has not met this burden.
8I further find that the applicant did not file a Notice of Motion requesting an extension of the initial submission deadline.
COSTS REQUEST
9I do not find the respondent has met the threshold needed to order costs.
10Rule 19.1 of the Licence Appeal Tribunal Rules, 2023 states that the Tribunal may award costs when “another party in a proceeding has acted unreasonably, frivolously, vexatiously, or in bad faith”. Rule 19.5 lists factors the Tribunal shall consider when determining whether to order costs (and, if so, how much).
11Highlighting how he did not withdraw the application before his submission deadline, as well as issues with document exchange, the respondent supports its costs request by submitting that the applicant’s “conduct is unreasonable, frivolous, vexatious, and/or in bad faith.” According to the respondent, it was “forced to incur the costs of preparing its written submissions”.
12I find the respondent has not established that the applicant’s behaviour merits a costs order. Though I recognize that the applicant’s actions breached the case conference report and order (a breach that prejudiced the respondent and impacted the Tribunal’s ability to carry out an efficient and effective process), I conclude that this breach is remedied through this decision. As such, I do not find a costs order is needed.
ORDER
13As the applicant has made no submissions and tendered no evidence in support of the claims before the Tribunal, the applicant has not established removal from the MIG, nor has he demonstrated entitlement to the disputed medical benefits, award, and interest.
14The respondent’s request for costs is denied.
15The application is dismissed.
Released: January 29, 2025
Craig Mazerolle
Vice-Chair