Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 23-012186/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:
Ricardo Romero
Applicant
and
Allstate Insurance Company of Canada
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Shelby Chung, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Ricardo Romero, the applicant, was involved in an automobile accident on August 29, 2021, 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, Allstate 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?
ii. Is the applicant entitled to a non-earner benefit of $185.00 per week from June 28, 2022 to December 1, 2023?
iii. Is the applicant entitled to the treatment proposed by Downsview Healthcare Inc., in treatment plans/OCF-18s (“plan”) as follows:
a) $669.00 for physiotherapy services, in a plan submitted on December 18, 2021; and
b) $1,700.00 for physiotherapy services, in a plan submitted on April 12, 2022?
iv. Is the applicant entitled to the treatment proposed by Promed Rehabilitation Centre in plans as follows:
a) $1,199.75 for physiotherapy services, in a plan submitted on May 4, 2022;
b) $3,905.35 for physiotherapy services, in a plan submitted on May 4, 2022;
c) $1,282.43 for physiotherapy services, in a plan submitted on July 27, 2022; and
d) $2,400.00 for a psychological assessment, in a plan submitted on August 3, 2022?
v. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3In the case conference report and order released on May 6, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for January 17, 2025. Notice of the written hearing was e-mailed to the parties on May 9, 2024.
4On December 16, 2024, the Tribunal e-mailed the parties as a reminder to provide submissions for the upcoming written hearing or to submit a Notice of Withdrawal if a settlement had been reached.
5The applicant’s initial submissions were due on December 18, 2024.
6The respondent filed its written submissions on January 2, 2025.
7The Tribunal has not received any further correspondence from the applicant.
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 9, 2024.
9The applicant has the onus of demonstrating that he should be removed from the MIG, and that he is entitled to a non-earner benefit and the medical benefits in dispute.
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 removal from the MIG, entitlement to a non-earner benefit, and entitlement to the medical benefits and interest in dispute. I further find that no Notice of Motion has been filed seeking to extend the applicant’s submission deadlines.
ORDER
11As 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, entitlement to a non-earner benefit, and entitlement to the medical benefits and interest in dispute.
12The application is dismissed.
Released: July 18, 2025
Tyler Moore Vice-Chair