Citation: Black v. Belair Insurance Company Inc., 2026 ONLAT 24-015498/AABS

Licence Appeal Tribunal File Number: 24-015498/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:

Timothy Black

Applicant

and

Belair Insurance Company Inc.

Respondent

DECISION

ADJUDICATOR: Nadia Mauro

APPEARANCES:

For the Applicant: Moninder Khattra, Counsel

For the Respondent: Mercedes Marin, Counsel

HEARD: By way of written submissions

OVERVIEW

1Timothy Black, the applicant, was involved in an automobile accident on December 5, 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, Belair Insurance Company Inc., and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

1. 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 limit (“MIG”)?
2. Is the applicant entitled to $3,803.91 for Physiotherapy Services, proposed by Align Physio and Wellness Inc. in an (“OCF-18”) dated June 12, 2023?
3. Is the applicant entitled to $3,030.71 for Physiotherapy Services, proposed by Align Physio and Wellness Inc. in an OCF-18 dated September 11, 2023?
4. Is the applicant entitled to $2,020.37 for a Psychological Assessment, proposed by Align Physio and Wellness Inc. in an OCF-18 dated March 18, 2023?
5. Is the applicant entitled to interest on any overdue payment of benefits?

RESULT

3The applicant’s injuries are predominantly minor as defined by the Schedule. As the applicant remains in the MIG, it is not necessary for me to determine whether the disputed treatment plans are reasonable and necessary.

4As there are no overdue benefits, the applicant is not entitled to interest.

PROCEDURAL ISSUES

The applicant’s evidence

5The respondent, in its submissions, raises issue with the clinical notes and records (“CNRs”) of Dr. Neil, referred by the applicant as “A - CNRs from Dr. Neil up to Dec 5, 2023”. The respondent submits that these CNRs should not be reviewed or considered by the Tribunal as they are not CNRs that pertain to the applicant and the applicant never served or advised that he intended to rely on these CNRs.

6I have reviewed the evidence, and I find that the CNRs of Dr. Neil are not medical records of the applicant. The applicant does not refer to these CNRs in his submissions, nor does the applicant list these CNRs on his document index. It appears that these CNRs were included in error. Given this, the CNRs of Dr. Neil will not be considered.

ANALYSIS

The applicant’s injuries are predominantly minor

7I find that the applicant has not proven, on a balance of probabilities, that his accident-related injuries warrant removal from the MIG.

8Section 18(1) of the Schedule provides that medical and rehabilitation benefits are limited to $3,500.0