Licence Appeal Tribunal File Number: 25-009969/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:
Neetu Deol
Applicant
and
Allstate Insurance Company of Canada
Respondent
PRELIMINARY ISSUE HEARING DECISION AND ORDER
ADJUDICATOR:
Tami Cogan
APPEARANCES:
For the Applicant:
Jasmine Patel, Counsel
For the Respondent:
Christina Parkes, Counsel
HEARD:
By way of written submissions
OVERVIEW
1Neetu Deol, the applicant, was involved in an automobile accident on September, 1, 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, Allstate Insurance Company of Canada, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (“Tribunal”) for resolution of the dispute.
PRELIMINARY ISSUE IN DISPUTE
2The preliminary issue to be decided is:
a. Is the applicant barred from proceeding to a hearing for all of the benefits claimed in this application because the applicant failed to attend insurer’s examinations under s. 44 of the Schedule?
result
3The applicant is statute-barred from proceeding with her application.
ANALYSIS
4I find the applicant is statute-barred from proceeding with her application because she did not attend the psychological insurer’s examination on July 15, 2024.
5Pursuant to ss. 44(1) and 55(1)2. of the Schedule an insurer may require the applicant to attend an insurer’s examination. If the applicant fails to attend without a reasonable explanation, then the insured person is barred from proceeding with an application.
(1) For the purposes of assisting an insurer to determine if an insured person is or continues to be entitled to a benefit under this Regulation for which an application is made, but not more often than is reasonably necessary, an insurer may require an insured person to be examined under this section by one or more persons chosen by the insurer who are regulated health professionals or who have expertise in vocational rehabilitation.
(1) Subject to subsection (2), an insured person shall not apply to the Licence Appeal Tribunal under subsection 280 (2) of the Insurance Act if:
The insurer has provided the insured person with notice in accordance with this Regulation that it requires an examination under section 44, but the insured person has not complied with that section.
Background
6The applicant submitted a treatment plan (“OCF-18”) in the amount of $2,599.21 on September 18, 2023. The applicant had already incurred $2,733.11 in medical and rehabilitation benefits. Therefore, the proposed treatment was above the Minor Injury Guideline (“MIG”). The OCF-18 was denied on October 2, 2023, in a letter of Explanation of Benefits (“EoB”).
7On May 10, 2024, the applicant was sent two Notices of Examination: 1) An orthopaedic assessment on June 6, 2024; and 2) A psychological assessment on July 15, 2024.
8The parties agree that the applicant did not attend either assessment.
9The application was filed on August 1, 2025.
Parties Positions
10The respondent submits that Notice of Insurer’s Examinations were proper and due to her non-attendance, she is statute barred from proceeding with her application. Also, the respondent submits that it did not receive any explanation from the applicant as to why she did not attend the examinations. The respondent further submits that the examinations were not re-scheduled after the case conference held on December 2, 2025, wherein the applicant stated she was willing to attend re-scheduled examinations, because over two years had passed since the OCF-18 submission, and the respondent has been prejudiced whereas the lapse in time potentially renders the findings of the assessments inaccurate when speaking to the OCF-18 in dispute.
11The applicant submits that correspondence was sent on June 20, 2024, requesting that the June 6th orthopaedic assessment be rescheduled. The respondent did not reschedule the assessment which has caused the applicant significant prejudice. Further, the applicant submits that the Notices of Examination did not meet the requirements of s. 44(5) of the Schedule.
12I have considered the email that the applicant is relying on as the communication to the respondent regarding the non-attendance on June 6, 2024, and her willingness to attend a re-scheduled assessment. I note that it is dated June 28, 2024, at 5:41pm; not June 20, 2024. I have considered that the email is addressed to “kelliot@assistplus.ca”. I find that I do not have evidence before me as to who “kelliot” is and if this is the correct person to notify. Nor do I have evidence that the email was received by its intended recipient.
13I find that “due to unforeseen circumstances” is not a reasonable explanation for her non-attendance because the applicant has not provided any detail as to what the circumstances were and whether any efforts were made to notify the Insurer in advance of the non-attendance. I note that the applicant’s submission, which provides an explanation in response to this preliminary