Thi Nguyen v. Economical Mutual Insurance Company, 2025 CanLII 86566

Licence Appeal Tribunal

Citation: Nguyen v. Economical Mutual Insurance Company, 2025 ONLAT 24-002019/AABS

Licence Appeal Tribunal File Number: 24-002019/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:

Thi Nguyen Applicant

and

Economical Mutual Insurance Company Respondent

DECISION

VICE-CHAIR: Tyler Moore

APPEARANCES:

For the Applicant: No Submissions

For the Respondent: Mirsa Duka, Counsel

HEARD: By Way of Written Submissions

OVERVIEW

1Thi Nguyen, the applicant, was involved in an automobile accident on September 9, 2022, 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, Economical Mutual 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 $3,080.64 for physical therapy, proposed by Pain Rehabilitation Clinic in a treatment plan/OCF-18 (“plan”) dated March 1, 2023?

iii. Is the applicant entitled to $3,200.80 for physiotherapy services, proposed by Pain Rehabilitation Clinic in a plan dated September 22, 2023?

iv. Is the applicant entitled to $2,200.00 for a chronic pain assessment, proposed by Disability Medicine Specialists in a plan dated July 7, 2023?

v. Is the applicant entitled to interest on any overdue payment of benefits?

ANALYSIS

3In the case conference report and order released on June 19, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for March 14, 2025. Notice of the written hearing was e-mailed to the parties on June 27, 2024.

4The applicant’s initial submissions were due on February 12, 2025.

5The respondent filed its written submissions on February 25, 2025.

6The Tribunal has not received any further correspondence from the applicant.

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 27, 2024.

8The applicant has the onus of demonstrating that they should be removed from the MIG, and that they are entitled to the medical benefits 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 they should be removed from the MIG, and that they are entitled to the medical benefits and interest being claimed. I further find that no Notice of Motion has been filed with the Tribunal seeking to extend the applicant’s submission deadlines.

ORDER

10The applicant remains in the MIG and is not entitled to $3,080.64 for physical therapy, $3,200.80 for physiotherapy services, and $2,200.00 for a chronic pain assessment.

11As no benefits are owing, the applicant is not entitled to interest.

12The application is dismissed.