Licence Appeal Tribunal File Number: 23-014254/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:
Felix Domchik
Applicant
and
CUMIS General Insurance Company
Respondent
DECISION
VICE-CHAIR:
Tyler Moore
APPEARANCES:
For the Applicant:
No Submissions
For the Respondent:
Mr. Peter Durant, J.D., Counsel
HEARD:
By Way Of Written Submissions
OVERVIEW
1Felix Domchik, the applicant, was involved in an automobile accident on June 19, 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, CUMIS General Insurance Company, 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. Is the applicant entitled to an income replacement benefit in the amount of $400.00 per week from August 30, 2023 to ongoing?
ii. Is the applicant entitled to $848.20 for Physiotherapy Services, proposed by Yonge Sheppard Health Centre in a treatment plan/OCF-18 (“plan”) dated November 3, 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 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, including the applicant directly, on May 9, 2024, using the contact information provided.
4On December 16, 2024, the applicant’s representative at the time filed a Removal of Representative form with the Tribunal and copied the applicant and the respondent.
5There has been no further correspondence from the applicant and the Tribunal has not received a request for an adjournment or a Notice of Withdrawal.
6The applicant’s initial submissions were due on December 18, 2024.
7The respondent filed its written submissions on January 2, 2025.
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 written 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.
9There has been no indication that the applicant intended to obtain new representation or that he took any steps to do so after December 16, 2024. There has also been no motion made seeking to extend the applicant’s submission deadlines, or request for an adjournment.
10The applicant has the onus of demonstrating entitlement to an income replacement benefit, medical benefit, interest, and an award.
11As no submissions have been filed with the Tribunal by the applicant, I find that he has not met the evidentiary burden to demonstrate entitlement to the income replacement benefit, medical benefit, award, and interest in dispute.
ORDER
12The applicant is not entitled to an income replacement benefit from August 30, 2023 and ongoing.
13The applicant is not entitled to $848.20 for physiotherapy services.
14As no benefits are owing, the applicant is not entitled to interest or an award.
15The application is dismissed.
Released: August 6, 2025
Tyler Moore
Vice-Chair