Sajjad Jillani v. Scottish and York Insurance Co., 2025 CanLII 89874

Citation: Jillani v. Scottish and York Insurance Co., 2025 ONLAT 24-001820/AABS

Licence Appeal Tribunal File Number: 24-001820/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:

Sajjad Jillani

Applicant

and

Scottish and York Insurance Co.

Respondent

DECISION

VICE-CHAIR: Tyler Moore

APPEARANCES:

For the Applicant: No Submissions

For the Respondent: Kathleen Mertes, Counsel

HEARD: By Way of Written Submissions

OVERVIEW

1Sajjad Jillani, the applicant, was involved in an automobile accident on August 9, 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, Scottish and York Insurance Co., 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 $2,618.20 for a chronic pain assessment, proposed by Healthspot Assessment Inc. in a treatment plan dated November 7, 2022?

iii. Is the applicant entitled to $2,460.00 for a psychological assessment, proposed by Healthspot Assessment Inc. in a treatment plan dated September 14, 2023?

iv. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?

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

ANALYSIS

3In the case conference report and order released on June 13, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for March 7, 2025. Notice of the written hearing was e-mailed to the parties on June 27, 2024, using the contact information provided.

4The applicant’s initial submissions were due on February 5, 2025.

5The respondent filed its written submissions on February 11, 2025.

6The Tribunal has not received any further correspondence from the applicant, and I find that there has been no Notice of Motion 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 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 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 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 they should be removed from the MIG, and that they are entitled to the medical benefits, award, and interest in dispute.

ORDER

10The applicant remains in the MIG and is not entitled to $2,618.20 for a chronic pain assessment, and $2,460.00 for a psychological assessment.

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

12The application is dismissed.