Nazha Al Aazab v. Jevco Insurance Company, 2026 CanLII 6234

Citation: Al Aazab v. Jevco Insurance Company, 2026 ONLAT 24-006173/AABS

Licence Appeal Tribunal File Number: 24-006173/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:

Nazha Al Aazab

Applicant

and

Jevco Insurance Company

Respondent

DECISION

VICE-CHAIR: Henry Harris

APPEARANCES:

For the Applicant: Georgiana Masgras, Counsel

For the Respondent: Olivia Hajdas, Counsel

HEARD: By way of written submissions

OVERVIEW

1Nazha Al Aazab (the “applicant”) was involved in an automobile accident on March 3, 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 Jevco Insurance Company (the “respondent”) 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 $4,093.00 for physiotherapy services, proposed by Mohannad Bakri in a treatment plan/OCF-18 (“plan”) submitted August 2, 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?

3The case conference report and order dated September 16, 2024 (the “CCRO”) also listed the Minor Injury Guideline (“MIG”) as being an issue in dispute. The respondent submits that MIG is no longer in dispute. It submits that by letter dated November 12, 2024, it advised the applicant that she had been removed from the MIG.

4I find that the respondent has provided evidence by way of a copy of its letter dated November 12, 2024, that confirms that the applicant has been removed from the MIG. As such, I find that the issue of MIG has been resolved and is no longer an issue in dispute.

RESULT

5The applicant is not entitled to the plan for physiotherapy services.

6The applicant is not entitled to interest or an award.

7The application is dismissed.

ANALYSIS

The applicant is not entitled to the plan for physiotherapy services

8I find that the applicant has not proven on a balance of probabilities that the plan for physiotherapy services is reasonable and necessary.

9To receive payment for a plan under s. 15 and 16 of the Schedule, the applicant bears the burden of demonstrating on a balance of probabilities that the benefit is reasonable and necessary as a result of the accident. To do so, the applicant should identify the goals of treatment, how the goals would be met to a reasonable degree and that the overall costs of achieving them are reasonable.

10The plan submitted August 2, 2023 prepared by Mr. Mohannad Bakri, physiotherapist, sought funding of $4,093.00 for physiotherapy services. The goals of the plan are identified as pain reduction, increase in strength and range of motion, and return to activities of normal living.

11The applicant submits that, as a result of the accident, she is experiencing sprain and strain of the thoracic spine, neck pain with associated musculoskeletal signs, and headaches. She argues these conditions require therapy for relief and recovery. The applicant’s submissions refer to the clinical notes and records (“CNRs”) of her family doctor, Dr. Wasan Abbas, and the CNRs of Fairview which appear to relate to a March 15, 2023 examination by Ms. Julie Kruis, chiropractor.

12The respondent submits that the plan is neither reasonable nor necessary as a result of the accident. The respondent relies on the insurer’s examination (“IE”) reports of Dr. Charanjit Sandhu, physician, dated March 5, 2024, and Dr. Brandon Kucher, neurologist, dated October 29, 2024, both of which found that plan was not reasonable and necessary. The respondent notes that Dr. Sandhu was of the opinion that, based on the nature of the injuries, the applicant would have achieved maximum therapeutic benefit from a facility-based treatment, given that almost one year had elapsed since the accident. Dr. Kucher found that, from a neurological perspective, the plan was not reasonable and necessary because there were no current objective neurological impairments.

13I find that the applicant has not provided compelling contemporaneous medical evidence to show that the plan for physiotherapy is reasonable and necessary. While the submissions directed me to the CNRs of her family doctor, she did not pinpoint any specific references to those that support her position. From my review of the CNRs, there was no mention of the accident other than receipt of an April 6, 2023 radiologist report which found normal results in the radiographs of the applicant’s chest, bilateral ribs, abdomen and bilateral shoulders. The CNRs of Fairview seem to be limited to a March 15, 2023 chiropractic examination by Ms. Kruis. There was no indication of any follow up visits after this initial examination, nor any reference to the plan that was submitted five months later. The applicant did not direct me to anything specific in the CNRs of Fairview to support her position.

14Further, I find the IE reports support the respondent’s position that the plans are not reasonable and necessary. Both Dr. Sandhu and Dr. Kucher conducted in-person assessments of the applicant and had access to the medical records provided by her for review, including the April 6, 2023 radiograph imaging, in reaching their respective opinions that the plan was not reasonable and necessary.

15Accordingly, I find that the applicant has not met her onus of demonstrating on a balance of probabilities that this plan is reasonable and necessary.

Interest

16Interest applies on the payment of any overdue benefits pursuant to s. 51 of the Schedule. Since no benefits are owing, interest does not apply.

Award

17The applicant sought an award under s. 10 of Reg. 664. Under s. 10, the Tribunal may grant an award of up to 50 per cent of the total benefits payable if it finds that an insurer unreasonably withheld or delayed the payment of benefits.

18As the respondent did not unreasonably withhold or delay payment of benefits, no award is payable.

ORDER

19For the reasons outlined above, I find that:

a. The applicant is not entitled to the plan in dispute, interest or an award; and

b. The application is dismissed.