Citation and File Number
Licence Appeal Tribunal File Number: 23-003900/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.
Parties
Between:
Paulo Soto
Applicant
and
Aviva Insurance Company of Canada
Respondent
Decision
ADJUDICATOR: Roderick Walker
APPEARANCES:
For the Applicant: Kayla Cuff, Paralegal
For the Respondent: Jessica Bacopulos, Counsel
HEARD: By way of written submissions
OVERVIEW
1Paulo Soto, the applicant, was involved in an automobile accident on October 16, 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, Aviva Insurance Company of Canada, 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 limit? Note: The parties agree the MIG limits have not been exhausted and that $223.14 remains in the MIG limits.
ii. Is the applicant entitled to a non-earner benefit of $185.00 per week from November 13, 2020, to October 16, 2022?
iii. Is the applicant entitled to $1,267.00 for chiropractic services proposed by Fit for Life Wellness and Rehabilitation Centre in a treatment plan/OCF-18 dated March 29, 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?
RESULT
3The applicant has suffered injuries that are minor and can be treated within the monetary limits of the MIG.
4The applicant is not entitled to the treatment plan, (OCF -18) for $1,267.00 for chiropractic services.
5The applicant does not suffer a complete inability to carry on a normal life as a result of injuries sustained in the subject accident and is therefore not entitled to a non-earner benefit.
6The applicant is not entitled to an award under s.