Licence Appeal Tribunal File Number: 24-002648/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:
Rochelle Macleod-Kennedy
Applicant
and
Optimum Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Rebecca Brown Greer, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Rochelle Macleod-Kennedy, the applicant, was involved in an automobile accident on December 6, 2021, 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, Optimum 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 $2,530.00 for a psychological assessment, proposed by Tier I Assessments Ltd. in a treatment plan/OCF-18 (“plan”) dated May 18, 2023?
iii. Is the applicant entitled to $1,349.72 for physiotherapy services, proposed by PhysioHeal in a plan dated March 8, 2022?
iv. Is the applicant entitled to $2,527.52 for physiotherapy services, proposed by PhysioHeal in a plan dated June 1, 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 July 19, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for April 17, 2025. Notice of the written hearing was e-mailed to the parties on July 25, 2024, using the contact information provided.
4On November 7, 2024, the applicant’s representative at the time filed a Removal of Representative form with the Tribunal.
5On November 12, 2024, the Tribunal e-mailed the applicant acknowledging the Removal of Representative and requested that the applicant confirm whether she would be seeking new representation.
6On April 11, 2025, the Tribunal e-mailed the applicant again, asking her to advise the Tribunal if she would be representing herself or seeking new representation. The Tribunal included a copy of the case conference report and order and the Notice of Written Hearing.
7The applicant’s initial submissions were due on March 18, 2025.
8The respondent filed its written submissions on April 4, 2025.
9The Tribunal has not received any further correspondence from the applicant, and the applicant has not filed a Notice of Motion seeking to extend her submission deadlines.
10The applicant has not filed a Notice of Withdrawal, and there has been no indication that the applicant intends, or has taken steps, to obtain new representation.
11Since 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 e-mail on July 25, 2024, and April 11, 2025.
12The 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.
13As 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.
ORDER
14The applicant remains in the MIG and is not entitled to the treatment plans in dispute.
15As no benefits are payable, the applicant is not entitled to interest or an award.
16The application is dismissed.
Released: September 24, 2025
Tyler Moore
Vice-Chair