Licence Appeal Tribunal File Number: 24-014079/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:
Radiya Al Sheikh
Applicant
and
Peel Mutual Insurance Company
Respondent
DECISION
ADJUDICATOR:
Caley Howard
APPEARANCES:
For the Applicant:
Mobina Khan, Counsel
For the Respondent:
Sonya Katrycz, Counsel
Interpreter:
Mohamad Al Chebli (Arabic language)
Court Reporter:
Kyle Climans
Heard by videoconference:
August 5, 2025
OVERVIEW
1Radiya Al Sheikh, the applicant, was involved in an automobile accident on October 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, Peel Mutual 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 a non-earner benefit (“NEB”) of $185.00 per week from November 30, 2022 to date and ongoing?
iii. Is the applicant entitled to the assessments proposed by Meditec Independent Medical Examinations, as follows:
a) $2,486.00 for an attendant care assessment, in an OCF-18/treatment plan (“treatment plan”) submitted November 29, 2022; and
b) $4,373.10 for a psychiatric assessment, in a treatment plan submitted November 29, 2022?
iv. Is the applicant entitled to $4,863.84 for a chiropractic services, proposed by Spinetec Health Care Solutions in a treatment plan submitted November 29, 2022?
v. Is the applicant entitled to interest on any overdue payment of benefits?
vi. Is the respondent entitled to costs?
3The respondent requested costs at the hearing. I have added it to the issues in dispute pursuant to Rule 19.2 of the Licence Appeal Tribunal Rules, 2023 (the “Rules”).
RESULT
4I find that:
i. The applicant remains within the MIG;
ii. The applicant is not entitled to an NEB;
iii. As the applicant is subject to the MIG, it is not necessary to consider whether the treatment plans are reasonable and necessary;
iv. As there are no overdue benefits, the applicant is not entitled to interest; and
v. The respondent is not entitled to costs.
PROCEDURAL ISSUES
Respondent may rely on the late-produced AutoPlus Report
5The respondent sought an order permitting it to rely on a document, a nine-page AutoPlus Report, which it did not disclose to the applicant until the day before the hearing. The respondent submitted that it was not sure why the document was not disclosed pursuant to the deadline set out in the Case Conference Report and Order because respondent’s counsel recently took over carriage of the file from a colleague. It submitted that the information in the document, which summarizes the insurance policies held by, and claims made by, the applicant in the years 2019 to 2025, was within the knowledge of the applicant.
6The applicant submitted that the document should not be admitted as it was not disclosed pursuant to the deadline set out in the Case Conference Report and Order.
7Pursuant to Rule 9.3 of the Licence Appeal Tribunal Rules, I considered the fact that the information in the document was within the applicant’s knowledge, and the fact that the applicant did not consent to the document being relied on at the hearing. I ordered that the respondent would be permitted to rely on the document, but I would give the document less weight to account for the potential prejudice caused by its late production.
8In any event, I did not rely on the document in coming to my decisions as set out below.
ANALYSIS
The applicant remains in the MIG
9I find that the applicant remains subject to the MIG.
10Section 18(1) of the Schedule provides that medical and rehabilitation benefits are limited to $3,500.00 if the insured sustains impairments that are predominantly a minor injury. Section 3(1) defines a “minor injury” as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an