Licence Appeal Tribunal File Number: 24-012478/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:
Dominique Surgeon
Applicant
and
TD General Insurance Company
Respondent
DECISION
ADJUDICATOR:
Jeff Chatterton
APPEARANCES:
For the Applicant:
No submissions
For the Respondent:
Deedra-Ann Lake, Counsel
HEARD: In Writing
OVERVIEW
1Dominique Surgeon, the applicant, was involved in an automobile accident on November 7, 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, TD General Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
PRELIMINARY ISSUES
2Is the applicant barred from proceeding to a hearing for the following benefits: Issues 3, 4 and 5, below because the applicant failed to attend an insurer’s examination under s. 44 of the Schedule?
SUBSTANTIVE ISSUES
3The issues to be decided in the hearing are:
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?
Is the applicant entitled to a non-earner benefit (“NEB”) of $185.00 per week from December 7, 2022, to date and on-going?
Is the applicant entitled to $2,050.00 for social worker assessment, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated April 24, 2024?
Is the applicant entitled to $1,270.00 for physiotherapy services, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated November 21, 2023?
Is the applicant entitled to $1,749.00 for physiotherapy services, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated September 29, 2023?
Is the applicant entitled to $2,300.00 for chronic pain assessment, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated May 24, 2023?
Is the applicant entitled to $2,641.62 for aqua therapy services, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated May 24, 2023?
Is the applicant entitled to $1,050.57 for physiotherapy services, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated April 21, 2023?
Is the applicant entitled to $2,300.00 for orthopaedic assessment, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated April 21, 2023?
Is the applicant entitled to $3,185.19 for psychological assessment, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated March 23, 2023?
Is the applicant entitled to $1,270.00 for chiropractic services, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated February 16, 2023?
Is the applicant entitled to $2,300.00 for attendant care assessment, proposed by Wynford Health/Assessment Services in a treatment plan/OCF-18 dated November 25, 2022?
Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?
Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
4The application is dismissed.
5I find that the applicant has not demonstrated that she should be removed from the MIG, or entitlement to an NEB, the treatment plans in dispute, interest or an award.
6As the application is dismissed in its entirety, it is not necessary to address the preliminary issue in dispute.
ANALYSIS
7The applicant did not attend the case conference on January 31, 2025. No reason was given for the applicant’s non-attendance.
8In the Case Conference Report and Order (“CCRO”), dated the same day, the Tribunal ordered the dispute to proceed to a written hearing. The Tribunal scheduled a written hearing for September 19, 2025. Notice of this written hearing was emailed to the parties, including the applicant and her counsel, using the email address they had provided on the application.
9Pursuant to the CCRO, the applicant’s written submissions were due August 22, 2025. The respondent filed its submissions on September 8, 2025, in compliance with the CCRO.
10The Tribunal contacted applicant’s counsel via email dated October 1, 2025, who informed the Tribunal via a return email dated the same day that they no longer represented the applicant. In that email, previous counsel referred the Tribunal to a licensed paralegal, stating that this was the applicant’s new legal representative.
11Via email October 2, 2025, the Tribunal contacted the identified paralegal to confirm whether they were the applicant’s new representative. This identified paralegal sent a return email dated October 6, stating he was unable to submit a Declaration of Representative form because he had been retained with respect to only the applicant’s tort claim and that he was not representing the applicant on her accident benefits claim in front of the Tribunal.
12The Tribunal sent an email directly to the applicant on January 12, 2026 to the email address specified in the application, asking for a confirmation of the applicant’s legal representative. This email was not answered. The Tribunal attempted again via Canada Post, using the address provided in the application, in a letter dated April 20, 2026. This letter was returned to the Tribunal unopened with a “Return to Sender” message. The Tribunal further sent a letter to the applicant dated May 1, 2026, asking for confirmation of the applicant’s representative, and included the Notice of Written Hearing and the CCRO, but did not receive a response.
13To date, the applicant has not filed any written hearing submissions, has not contacted the Tribunal, and has not filed a Notice of Withdrawal.
14Given that I find the applicant had notice of the written hearing, I will proceed with the written hearing pursuant to s. 7(2) of the Statutory Powers Procedure Act (SPPA). This section provides that where notice of a written hearing has been given to a party to a proceeding in accordance with the SPPA, the Tribunal may proceed without the party’s participation and the party is not entitled to any further notice in the proceeding.
15The applicant has the onus of demonstrating that her accident-related impairments warrant removal from the MIG, entitlement to NEBs, the treatment plans in dispute, interest, and an award.
16As no submissions or evidence have been filed with the Tribunal by the applicant, I find the applicant has not met her evidentiary burden to demonstrate that she should be removed from the MIG or entitlement to the substantive issues in dispute.
Preliminary Issues
17Given that the application is dismissed and the applicant has not established entitlement to any substantive benefits, it is not necessary to address the preliminary issue in dispute. The issue is effectively moot.
ORDER
18The application is dismissed.
i. As no submissions or evidence have been filed with the Tribunal by the applicant, I find that the applicant not demonstrated that removal from the MIG is warranted, or entitlement to the substantive issues in dispute.
ii. As the application is dismissed in its entirety, it is not necessary to address the preliminary issue.
Released: June 18, 2026
Jeff Chatterton
Adjudicator