Citation: Sorima v. Novex Insurance Company, 2026 ONLAT 24-009937/AABS

Licence Appeal Tribunal File Number: 24-009937/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:

Ronnie Sorima

Applicant

and

Novex Insurance Company

Respondent

DECISION

ADJUDICATOR:

Laura Goulet

APPEARANCES:

For the Applicant:

Mariana Slomyanski, Counsel (no submissions received)

For the Respondent:

Emma Duggan, Counsel

HEARD:

By way of written submissions

OVERVIEW

1Ronnie Sorima, the applicant, was involved in an automobile accident on April 3, 2017, 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, Novex 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. Is the applicant entitled to $23,308.60 for a catastrophic impairment assessment, proposed by HM Medical Network Ltd. in a treatment plan/OCF-18 (“treatment plan”) dated December 4, 2023?

ii. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?

iii. Is the applicant entitled to interest on any overdue payment of benefits?

RESULT

3The applicant is not entitled to the treatment plan for a catastrophic impairment assessment or interest.

4The respondent is not liable to pay an award.

5The application is dismissed.

ANALYSIS

6A case conference in this matter took place on May 7, 2025. The applicant and respondent attended, along with their representatives. In the Case Conference Report and Order released to the parties on May 8, 2025 (“CCRO”), the Tribunal ordered the dispute to proceed to a written hearing. A Notice of Written Hearing was e-mailed to the parties on May 13, 2025. The Tribunal scheduled a written hearing for November 14, 2025.

7Pursuant to the CCRO, the applicant’s initial submissions and evidence were due 30 calendar days prior to the scheduled hearing, the respondent’s submissions and evidence were due 14 calendar days prior to the hearing, and the applicant’s reply submissions were due 7 calendar days prior to the hearing.

8Accordingly, I find that the applicant’s written submissions were due on October 15, 2025. I note that the applicant has not filed a Notice of Motion with the Tribunal seeking to extend their submission deadlines.

9The respondent directs me to email correspondence dated October 15, 20, and 22, 2025 from its counsel addressed to the applicant’s counsel, inquiring about their submissions.

10The respondent submits that the applicant has failed to comply with the CCRO, failed to provide requested information, failed to tender their submissions for the hearing, failed to meet their burden of proof, and had sufficient notice of the hearing.

11I am satisfied that the Notice of Written Hearing, as well as the email correspondence from the respondent, were sent to the applicant’s counsel at the correct email address.

12I find that the Tribunal has met its notice obligations and that I may proceed with the hearing pursuant to s. 7(2) of the Statutory Powers Procedure Act, RSO 1990, c S.22 (“SPPA”).

13Proceeding with a written hearing where a party fails to participate, under s. 7(2) of the 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.

14I find that the applicant had notice of the written hearing by way of e-mail dated May 13, 2025, as required by ss. 6(1) and 6(4) of the SPPA. I am also satisfied that neither party requested a change of format from a written hearing under s. 6(4)(b) of the SPPA.

15The applicant has the onus of demonstrating on a balance of probabilities that they are entitled to the medical benefit in dispute.

16Since the applicant has not filed submissions or evidence with the Tribunal, I find that the applicant has not met their onus, and they are not entitled to the treatment plan for a catastrophic impairment assessment, an award or interest.

ORDER

17For the above reasons, I find:

i. The applicant is not entitled to the treatment plan for a catastrophic impairment assessment or interest.

ii. The respondent is not liable to pay an award.

iii.

iii. The application is dismissed.