Licence Appeal Tribunal File Number: 23-014495/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:
George T Raymand
Applicant
and
Pembridge Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Loretta De Thomasis, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1George Raymand, the applicant, was involved in an automobile accident on January 5, 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, Pembridge 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. 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 (“MIG”) limit?
ii. Is the applicant entitled to $2,460.00 for psychological services, proposed by Healthspot Assessments Inc. in a treatment plan/OCF-18 dated August 4, 2022?
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 29, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for February 14, 2025. Notice of the written hearing was e-mailed to the parties on June 6, 2024, using the contact information provided.
4The applicant’s initial submissions were due on January 15, 2025.
5The respondent filed its written submissions on January 31, 2025.
6The Tribunal has not received any further correspondence from the applicant, and I find that no Notice of Motion has been filed seeking to extend the applicant’s submission deadlines.
7Since 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 June 6, 2024.
8The applicant has the onus of demonstrating that he should be removed from the MIG, and that he is entitled to the medical benefit and award in dispute.
9As 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, and that he is entitled to the medical benefit, award, and interest in dispute.
ORDER
10The applicant remains in the MIG and is not entitled to $2,460.00 for psychological services.
11As no benefits are owing, the applicant is not entitled to interest or an award.
12The application is dismissed.
Released: August 18, 2025
Tyler Moore
Vice-Chair