Licence Appeal Tribunal
Licence Appeal Tribunal File Number: 24-000742/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:
Mariah Martinez
Applicant
and
Co-operators General Insurance Company
Respondent
Decision
Vice-Chair: Tyler Moore
Appearances:
For the Applicant: No Submissions
For the Respondent: Amanda Lennox, Counsel
Heard: By Way of Written Submissions
Overview
1Mariah Martinez, the applicant, was involved in an automobile accident on May 7, 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, Co-operators 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. 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 limit?
ii. Is the applicant entitled to $1,372.12 for physiotherapy services, proposed by Janki Patel, Activa Kitchener in a treatment plan/OCF-18 ("plan") dated February 27, 2023?
iii. Is the applicant entitled to $286.78 ($1,347.12 less $1,060.34 approved) for physiotherapy services, proposed by Kamalpreet Kaur Bains, Active Kitchener in a plan dated September 14, 2022?
iv. Is the applicant entitled to $1,999.00 for other disputes, proposed by Alexander Short Story Purse, submitted on a claim form (OCF-6) dated September 13, 2022?
v. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
vi. Is the applicant entitled to interest on any overdue payment of benefits?
Analysis
3In the case conference report and order released on June 25, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled the written hearing for March 21, 2025. Notice of the written hearing was e-mailed to the parties on June 7, 2024, using the contact information provided.
4On July 5, 2024, the applicant's representative at the time filed a Removal of Representative form with the Tribunal. The Removal of Representative was acknowledged by the Tribunal on July 7, 2024.
5The applicant's initial submissions were due on February 19, 2025.
6The respondent filed its written submissions on March 7, 2025.
7The applicant e-mailed the Tribunal on March 7, 2025, in response to receiving the respondent's written submissions. The applicant advised the Tribunal that she would be completing and filing a Notice of Withdrawal form because she did not want to proceed with the hearing.
8The Tribunal has not received a completed Notice of Withdrawal form from the applicant.
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 by way of e-mail on June 7, 2024.
10The applicant has the onus of demonstrating that she should be removed from the MIG, and that she is entitled to the medical benefits and award 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 she should be removed from the MIG, and that she is entitled to the medical benefits, award, and interest in dispute. 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 she is not entitled to the medical benefits in dispute.
13As no benefits are owing, the applicant is not entitled to interest or an award.
14The application is dismissed.
Released: September 12, 2025
__________________________
Tyler Moore
Vice-Chair