Licence Appeal Tribunal File Number: 23-014473/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:
Deka Ainanshe
Applicant
and
Belair
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Eluxmeenah Rishihesan, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Deka Ainanshe, the applicant, was involved in an automobile accident on July 20, 2019, 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, 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?
ii. Is the applicant entitled to $2,460.00 for a chronic pain assessment, proposed by Health Spot Assessments Inc. in a treatment plan dated October 31, 2023?
iii. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
iv. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3In the case conference report and order released on May 8, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for January 24, 2025. Notice of the written hearing was e-mailed to the parties on May 16, 2024.
4The applicant’s initial submissions were due on December 27, 2024.
5The respondent filed its written submissions on January 10, 2025.
6On February 3, 2025, the Tribunal e-mailed the parties indicating that no written submissions were received from the applicant and asking the parties to confirm whether the matter had been settled. The Tribunal included a copy of the Notice of the written hearing.
7No further correspondence has been received from the parties, and the Tribunal has not received a Notice of Withdrawal.
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 by way of e-mail on May 16, 2024, and February 3, 2025.
9The applicant has the onus of demonstrating that they should be removed from the MIG, and entitlement to the medical benefit and award in dispute.
10As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not demonstrated that they should be removed from the MIG, and that they are entitled to the medical benefit, award, and interest in dispute. I further find that no Notice of Motion has been filed seeking to extend the applicant’s submission deadlines.
ORDER
11The applicant remains in the MIG and is not entitled to $2,460.00 for a chronic pain assessment.
12As no benefits are owing, the applicant is not entitled to interest or an award.
13The application is dismissed.
Released: July 24, 2025
Tyler Moore
Vice-Chair