Citation: Gerasimopoulos v. Co-operators General Insurance Company, 2026 ONLAT 24-003018/AABS

Licence Appeal Tribunal File Number: 24-003018/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:

Anastasios Gerasimopoulos

Applicant

and

Co-operators General Insurance Company

Respondent

DECISION

ADJUDICATOR: Brian Norris

APPEARANCES:

For the Applicant: Kristoffer Diocamp, Counsel

For the Respondent: Eric Grossman, Counsel

HEARD: By way of written submissions

OVERVIEW

1Anastasios Gerasimopoulos (“the Applicant”) was involved in an automobile accident on February 24, 2017, and sought benefits from Co-operators General Insurance Company (“the Respondent”) pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The Applicant sought a determination that he sustained a catastrophic impairment as a result of the accident, which the Respondent denied. The Applicant applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

i. Has the Applicant sustained a catastrophic impairment under criterion 4 as defined by the Schedule?

ii. Is the Respondent liable to pay an award under section 10 of Regulation 664 because it unreasonably withheld or delayed payments to the Applicant?

RESULT

3The Applicant has not demonstrated that he sustained a catastrophic impairment pursuant to criterion 4 of the Schedule.

4No award is payable.

BACKGROUND

5The Applicant was the driver of a vehicle which was struck on the front corner on the driver’s side by another vehicle making a left turn on a busy suburban roadway. He exited the vehicle independently and was mobile at the scene of the accident when emergency medical services arrived. The Applicant was taken by ambulance from the scene of the accident to the hospital and was examined.

6Clinical notes and records (“CNRs”) from the hospital indicate that the Applicant initially reported general body pain, mostly in the low back, but the CNRs note that no neck pain was reported, and no neurological deficits were noted. Later, upon reassessment, the Applicant reported pain in the left side of his neck and that his back pain was radiating down his legs. The Applicant was discharged from the hospital after x-rays were taken and indicated no evidence of trauma in the neck and back. Notably, the CNRs from the hospital do not mention that the Applicant hit his head in the accident, nor do the records endorse complaints of confusion or cognitive dysfunction.

7The Applicant followed up with his family physician, Dr. M. Bibi, on March 6, 2017. There it is noted that the visit was “post mva – concussion - ”. Dr. Bibi