Licence Appeal Tribunal File Number: 24-000290/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:
Fakhar Uz Zaman
Applicant
and
Certas Home and Auto Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Sandra Buhain, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Fakhar Uz Zaman, the applicant, was involved in an automobile accident on August 18, 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, Certas Home and Auto 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 an income replacement benefit in the amount of $400.00 per week from August 25, 2021 to date and ongoing?
iii. Is the applicant entitled to the treatment plans/OCF-18s (“plans”) proposed by Safe Space Rehabilitation Centre (formerly Life Point Medical Inc.), as follows:
a. $150.25 ($1,233.35 less $1,083.10 approved) for chiropractic services in a plan dated January 10, 2022; and
b. $4,538.72 for psychological services in a plan dated March 14, 2022?
iv. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3In the case conference report and order released on July 29, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for May 2, 2025. Notice of the written hearing was e-mailed to the parties on August 1, 2024, using the contact information provided.
4On August 26, 2024, the applicant’s representative at the time filed a Removal of Representative request form with Tribunal. The Tribunal acknowledged the request by e-mail on August 28, 2024, and requested the applicant’s updated contact information.
5On October 10, 2024, the Tribunal e-mailed the applicant requesting confirmation whether he would be obtaining new representation or if he would be representing himself going forward.
6The applicant’s initial submissions were due on April 2, 2025.
7The respondent filed its written submissions on April 14, 2025.
8The Tribunal has not received any further correspondence from the applicant. There has been no indication that the applicant intends to obtain new representation, or evidence that he has taken steps to do so since August 2024.
9The applicant has not filed a Notice of Withdrawal, and I find that no Notice of Motion has been filed seeking to extend the applicant’s submission deadlines.
10Since 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 August 1, 2024.
11The applicant has the onus of demonstrating that he should be removed from the MIG, that he is entitled to an income replacement benefit, and that he is entitled to the medical benefits in dispute.
12As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not met the evidentiary burden to demonstrate that he should be removed from the MIG, that he is entitled to an income replacement benefit, and that he is entitled to the medical benefits and interest in dispute.
ORDER
13The applicant remains in the MIG and is not entitled to an income replacement benefit.
14The applicant is not entitled to the medical benefits in dispute.
15As no benefits are payable, the applicant is not entitled to interest.
16The application is dismissed
Released: September 24, 2025
Tyler Moore
Vice-Chair