Licence Appeal Tribunal File Number: 24-003111/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:
Nahrain Zaya SL Slaiwa
Applicant
and
Certas Direct Insurance Company
Respondent
DECISION
VICE-CHAIR:
Tyler Moore
APPEARANCES:
For the Applicant:
No Submissions
For the Respondent:
Norma Barron, Counsel
HEARD:
By Way of Written Submissions
OVERVIEW
1Nahrain Zaya SL Slaiwa, the applicant, was involved in an automobile accident on August 16, 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, Certas Direct 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 $2,974.00 for chronic pain assessment, proposed by Complete Rehab Centre in a treatment plan/OCF-18 ("plan") dated August 11, 2023?
iii. Is the applicant entitled to $2,852.05 for psychological services, proposed by Complete Rehab Centre in a plan dated August 16, 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 July 19, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled the written hearing for April 25, 2025. Notice of the written hearing was e-mailed to the parties on July 25, 2024, using the contact information provided.
4On March 20, April 1, and April 25, 2025, the Tribunal e-mailed the parties to advise that the applicant's initial submissions had not been received. The parties were asked to advise the Tribunal if the matter had settled.
5On May 6, 2025, the respondent e-mailed the Tribunal to confirm that the matter had not settled.
6The applicant's initial submissions were due on March 26, 2025.
7The respondent filed its written submissions on April 10, 2025.
8Since 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 July 25, 2024.
9The 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.
10As 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. I further find that no Notice of Motion has been filed seeking to extend the applicant's submission deadlines.
ORDER
11The applicant remains in the MIG and is not entitled to the medical benefits in dispute.
12As no benefits are owing, the applicant is not entitled to interest or an award.
13The application is dismissed.
Released: September 22, 2025
__________________________
Tyler Moore
Vice-Chair