Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 23-015764/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:
Suresh Seenithamby Pushparasa
Applicant
and
Pembridge Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Brandon Orct, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Suresh Seenithamby Pushparasa, the applicant, was involved in an automobile accident on October 4, 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, 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 $4,249.00 for chiropractic services, proposed by GTA Chiropractic Center Inc. in a treatment plan/OCF-18 ("plan") dated March 28, 2023?
iii. Is the applicant entitled to $3,949.00 for chiropractic services, proposed by GTA Chiropractic Center Inc. in a plan dated June 1, 2023?
iv. Is the applicant entitled to $2,179.22 for a comprehensive mental health assessment, proposed by Community Health and Counselling Services Inc. in a plan dated September 14, 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 10, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing on March 7, 2025. Notice of the written hearing was e-mailed to the parties on June 13, 2024.
4On June 18, 2024, the applicant's representative filed a Removal of Representative form with the Tribunal and provided the applicant's personal contact information. On that same date, the Tribunal e-mailed the applicant to request whether he would be obtaining new representation or representing himself going forward.
5On June 20, 2024, the Tribunal e-mailed the applicant after there was no response to the June 18, 2024 e-mail. The Tribunal also reminded the applicant about his upcoming March 7, 2025 hearing date.
6The Tribunal has not received any further correspondence from the applicant, and there is no indication that the applicant has taken steps to obtain new representation after the Removal of Representative was acknowledged by the Tribunal in June 2024.
7The applicant's initial submissions were due on February 5, 2025.
8The respondent filed its written submissions on February 20, 2025.
9Since 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.
10The 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.
11As 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 seeking to extend the applicant's submission deadlines.
ORDER
12The applicant remains in the MIG, and is not entitled to $4,249.00 for chiropractic services, $3,949.00 for chiropractic services, and $2,179.22 for a comprehensive mental health assessment.
13As no benefits are payable, the applicant is not entitled to interest.
14The application is dismissed.
Released: August 22, 2025
__________________________
Tyler Moore
Vice-Chair