Mory v. Belair Insurance Company Inc., 2025 CanLII 99912

Licence Appeal Tribunal

Citation: Mory v. Belair Insurance Company Inc., 2025 ONLAT 24-003987/AABS

Licence Appeal Tribunal File Number: 24-003987/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:

Christopher Mory

Applicant

and

Belair Insurance Company Inc.

Respondent

DECISION

VICE-CHAIR:

Tyler Moore

APPEARANCES:

For the Applicant:

No Submissions

For the Respondent:

Paras Gogna, Counsel

HEARD:

By Way of Written Submissions

OVERVIEW

1Christopher Mory, the applicant, was involved in an automobile accident on January 25, 2023, 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, Belair Insurance Company Inc., and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The Preliminary issue in dispute is:

i. Is the applicant barred from proceeding to a hearing for the following benefits: psychological services (item ii(c)), psychological assessment (item ii(d), and other goods and services (item 3(g) because the applicant failed to attend an insurer’s examination under s. 44 of the Schedule?

3The Substantive 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 the assessments and treatments proposed by Alma Rehab Inc., as follows:

a) $3,244.58 for physiotherapy services, in a treatment plan submitted May 30, 2023;

b) $3,512.56 for physiotherapy services, in a treatment plan submitted October 31, 2023;

c) $1,995.47 for psychological services, in a treatment plan submitted September 21, 2023; and

d) $1,995.33 for a psychological assessment, in a treatment plan submitted May 17, 2023?

iii. Is the applicant entitled to the assessments and treatments proposed by Ontario Independent Assessment Centre Inc., as follows:

a) $2,397.75 for an orthopaedic assessment, in a treatment plan submitted August 31, 2023;

b) $2,397.75 for a functional abilities evaluation, in a treatment plan submitted August 31, 2023;

c) $2,657.75 for a neurological assessment, in a treatment plan submitted December 4, 2023;

d) $2,667.75 for a chronic pain assessment, in a treatment plan submitted December 4, 2023;

e) $2,397.75 for a functional cognitive assessment, in a treatment plan submitted December 11, 2023;

f) $3,315.41 for other assistive devices, in a treatment plan submitted December 4, 2023; and

g) $2,844.20 for other goods and services (personal trainer), in a treatment plan submitted February 21, 2024?

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

4In the case conference report and order released on August 1, 2024, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing on May 9, 2025. Notice of the written hearing was e-mailed to the parties on August 8, 2024, using the contact information provided.

5On February 24, 2025, the applicant’s representative at the time filed a Removal of Representative form with the Tribunal.

6On February 25, 2025, the Tribunal acknowledged the applicant’s request for Removal of Representative by e-mail and requested that the applicant confirm if he would be obtaining new representation or proceeding as a self-represented individual.

7On April 7, 2025, the Tribunal mailed the applicant the Notice of Written Hearing.

8The applicant’s initial submissions were due on April 9, 2025.

9The respondent filed its written submissions on April 22, 2025.

10The Tribunal has not received any further correspondence from the applicant, and there is no indication that the applicant has taken steps, or intends, to obtain new representation since February 2025. I further find that no Notice of Motion has been filed seeking to extend the applicant’s submission deadlines.

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 way of e-mail on August 8, 2024, and by way of regular mail after it was mailed to him on April 7, 2025.

12The 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.

13As 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 form the MIG, and that he is entitled to the medical benefits, award, and interest in dispute.

ORDER

14The applicant remains in the MIG and is not entitled to the medical benefits in dispute.

15As no benefits are payable, the applicant is not entitled to interest or an award.

16The application is dismissed.