Licence Appeal Tribunal File Number: 25-001521/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:
German Arenas Serna
Applicant
and
Definity Insurance Company
Respondent
DECISION
ADJUDICATOR:
Jeff Chatterton
APPEARANCES:
For the Applicant:
No Submissions
For the Respondent:
Mirsa Duka, Counsel
HEARD: In Writing
May 8, 2026
OVERVIEW
1German Arenas Serna, the applicant, was involved in an automobile accident on November 14, 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, Definity 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 of $185.00 per week from November 14, 2023, and ongoing??
iii. Is the applicant entitled to $2,443.36 for chiropractic services, proposed by Pro Life Wellness in a treatment plan/OCF-18 (“plan”) dated November 14,2024?
iv. Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
3As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not, on the balance of probabilities, demonstrated he should be removed from the MIG.
4Neither has he demonstrated entitlement to a non-earner benefit, the treatment plan in dispute, nor interest.
5The application is dismissed.
ANALYSIS
6The applicant did not attend the case conference but was represented by Counsel. In the case conference report and order released May 5, 2025, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for November 14, 2025. Notice of this written hearing was emailed to the parties on May 13, 2025, using the contact information provided. The applicant was included on the May 13, 2025, email.
7The applicant’s counsel informed the Tribunal they would no longer be representing the applicant on May 15, 2025. The applicant’s counsel was removed as the representative of record in accordance with Rule 24 of the Licence Appeal Tribunal Rules, 2023 (Rules).
8The applicant’s initial written submissions were due on October 15, 2025. The Tribunal attempted to contact the applicant on November 6, 2025, to ask if he still intended to proceed, and if he would be self-represented. The email was not returned as undeliverable, and no reply was received. There is no evidence that the applicant’s address changed or was otherwise incorrect in Tribunal records. If the applicant’s address differed from what was originally provided to the Tribunal, he had an obligation under Rule 4.4 of the Rules to notify the Tribunal of the correct address.
9The respondent also reports that it has attempted to contact the applicant on multiple occasions and has not received a response.
10Proceeding with a written hearing where a party fails to participate, under s. 7(2) of the Statutory Powers Procedure Act, RSO 1990, c. S.22, (SPPA) requires the Tribunal to be satisfied that the absent party received notice of the written hearing that complies with ss. 6(1) and 6(4) of the SPPA. I find that the applicant did receive notice as required by the SPPA.
11The applicant has the onus of demonstrating he should be removed from the MIG, as well as the onus of demonstrating entitlement to a non-earner benefit, the treatment plan in dispute, and interest.
12The applicant has not filed submissions. There has been no motion made seeking to extend the submission deadline, and no Notice of Withdrawal has been received from the applicant.
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 entitlement to these substantive issues.
ORDER
14As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant has not, on the balance of probabilities, demonstrated he should be removed from the MIG.
15Neither has he demonstrated entitlement to a non-earner benefit, the treatment plan in dispute, nor interest.
16The application is dismissed.
Released: May 8, 2026
__________________________
Jeff Chatterton
Adjudicator