Licence Appeal Tribunal File Number: 24-001851/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:
Rajesh Bhardwaj
Applicant
and
The Dominion of Canada General Insurance Company
Respondent
DECISION
VICE-CHAIR: Tyler Moore
APPEARANCES:
For the Applicant: No Submissions
For the Respondent: Sharon Dagan, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Rajesh Bhardwaj, the applicant, was involved in an automobile accident on June 20, 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, The Dominion of Canada 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 (“MIG”) limit?
ii. Is the applicant entitled to $3,743.22 for physiotherapy services, proposed by HM Medical Network Ltd., in a treatment plan/OCF-18 (“plan”) submitted July 18, 2022 and denied July 18, 2022?
iii. Is the applicant entitled to $2,832.90 for a chronic pain assessment, proposed by HM Medical Network Ltd., in a plan submitted August 9, 2023 and denied August 15, 2023?
iv. Is the applicant entitled to $27,534.80 or a multi-disciplinary catastrophic assessment, proposed by HM Medical Network Ltd., in a plan submitted September 13, 2022 and denied September 15, 2022?
v. Is the applicant entitled to $2,200.00 for a psychological assessment, proposed by HM Medical Network Ltd., in a plan submitted July 7, 2022 and denied July 8, 2022?
vi. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
vii. Is the applicant entitled to interest on any overdue payment of benefits?
ANALYSIS
3In the case conference report and order released on July 15, 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 18, 2024, using the contact information provided.
4The applicant’s initial submissions were due on March 18, 2025.
5The respondent filed its written submissions on April 3, 2025.
6I find that the applicant has not filed a Notice of Motion with the Tribunal seeking to extend his submission deadlines, or a Notice of Withdrawal.
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 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 18, 2024.
8The applicant has the onus of demonstrating that he should be removed from the MIG, and that he is 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 met the evidentiary burden to demonstrate that he should be removed from the MIG, and that he is entitled to the medical benefits, award, and interest in dispute.
ORDER
10The applicant remains in the MIG and is not entitled to the treatment plans in dispute.
11As no benefits are payable, the applicant is not entitled to interest or an award.
12The application is dismissed.
Released: September 25, 2025
Tyler Moore
Vice-Chair