Citation: Alves v. Co-operators General Insurance Company, 2026 ONLAT 24-006758/AABS

Licence Appeal Tribunal File Number: 24-006758/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:

Rivaldo Alves

Applicant

and

Co-operators General Insurance Company

Respondent

DECISION

ADJUDICATOR:

Ulana Pahuta

APPEARANCES:

For the Applicant:

No submissions

For the Respondent:

David Raposo, Counsel

HEARD:

In writing

OVERVIEW

1Rivaldo Alves, the applicant, was involved in an automobile accident on March 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, Co-operators General 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:

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 (“MIG”) limit?.

2. Is the applicant entitled to an income replacement benefit (“IRB”) in the amount of $20.00 per week from May 24, 2024, and ongoing?

3. Is the applicant entitled to the services proposed by Body Dynamics Inc., in a treatment plan/OCF-18 (“plan”) as follows:

i. $3,587.10 for physiotherapy services, in a plan submitted October 6, 2023, and denied October 17, 2023;

ii. $3,859.23 for physiotherapy services, in a plan submitted July 5, 2023, and denied July 7, 2023; and

iii. $3,944.23 for physiotherapy services, in a plan submitted July 5, 2023, and denied July 7, 2023?

4. Is the applicant entitled to the assessments proposed by Body Dynamics Inc., as follows:

i. $2,219.74 for a psychological assessment, in a treatment plan submitted June 26, 2023, and denied June 27, 2023; and

ii. $2,413.00 for a chronic pain assessment submitted March 21, 2024, and denied April 3, 2024?

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

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

RESULT

3I find that:

i. The applicant is not removed from the MIG;

ii. The applicant is not entitled to IRBs;

iii. The applicant is not entitled to the treatment plans in dispute, interest or an award.

ANALYSIS

4In the Case Conference Report and Order dated October 23, 2024, the Tribunal ordered this dispute to proceed to a written hearing. The written hearing was scheduled for July 11, 2025. Notice of the written hearing was emailed to the parties on October 29, 2024.

5On June 10, 2025, the applicant’s legal representative filed a Removal of Representative form requesting to remove himself as the applicant’s legal representative. By email dated June 10, 2025, the Tribunal acknowledged the Removal of Representative form, that the Tribunal’s records had been updated to reflect the withdrawal and that adjudicative events for the application would proceed as scheduled.

6The applicant’s written submissions were due on June 11, 2025. No written submissions were filed by the applicant. Also on June 11, 2025, the Tribunal emailed the applicant and inquired whether the applicant would be proceeding with his application, whether he would be proceeding as a self-represented party or whether he was seeking new counsel, and included links to online resources in the event the applicant chose to proceed with his application.

7As no written submissions were filed by the applicant, the respondent filed a Notice of Motion on June 23, 2025 seeking a dismissal of the application as abandoned under Rule 3.4 of the Licence Appeal Tribunal Rules. On June 25, 2025, the Tribunal set the respondent’s motion to be heard at this written hearing.

8The applicant has not filed any written submissions for this hearing to date, and the Tribunal has not received any further correspondence from the applicant. However, the applicant has not filed a Notice of Withdrawal with the Tribunal, and the file has not been closed. I will therefore proceed with the hearing pursuant to s. 7(2) of the Statutory Powers Procedure Act. I find that the parties had notice of the written hearing by way of the Tribunal’s email of October 29, 2024, and the Tribunal’s follow-up email of June 10, 2025.

9The applicant has the onus of demonstrating that his accident-related impairments warrant removal from the MIG, and that he is entitled to IRBs, the treatment plans in dispute, interest and an award. As the applicant has not filed any written hearing submissions with the Tribunal, I find that the applicant has not met his burden of demonstrating that removal from the MIG is warranted, or that he is entitled to IRBs, the treatment plans in dispute, interest or an award. The application is dismissed.

ORDER

10For the reasons outlined above I find that:

i. The applicant is not removed from the MIG;

ii. The applicant is not entitled to IRBs;

iii. The applicant is not entitled to the treatment plans in dispute, interest or an award.

11The application is dismissed.