Prepare the application by an injured person form and a certificate of service of the Application form on the Insurance Company found on Tribunals Ontario website and also a letter to the Insurance Company serving the application and a letter to the LAT filing all necessary material based on the given scenario:

Instructions

You are a licensed paralegal (LSO #P12345) and work for a personal injury firm, Sheridan Paralegal Services located at 7899 McLaughlin Road, Brampton, Ontario L6Y 5H9, PO Box 12, tel: 905-555-1313, fax: 905-555-1414. Use your Sheridan Outlook email address . If working with a partner, use one partner's email address.

On July 31, 2022, a client, Stephan Malatesta, was involved in a motor vehicle accident. He was travelling eastbound at the speed limit in the curb lane on Britannia Road in Mississauga (just east of Mavis Road) when a car travelling in the lane next to him changed lanes abruptly in front of him. He tried to stop but it was raining, and his wheels skidded into the back of the other car. The collision was severe, and Stephan's airbag was deployed. Emergency services were called, and an ambulance took Stephan to Credit Valley Hospital in Mississauga. The driver of the other vehicle was charged with careless driving under the Highway Traffic Act. Stephan was not charged. At the hospital, it was determined that Stephan suffered whiplash, a herniated back disc, a fractured right wrist (he is right-handed), two cracked ribs, a concussion, burns and abrasions from the air bag, and soft tissue injuries. He remained in hospital for four days and was discharged on August 4, 2022.

Stephan's partner notified the insurance company of the accident by phone on August 1, 2022. The insurance company details are as follows: Able Insurance Company, 212 - 1400 Hurontario Street, Mississauga, Ontario L3L 3L3 tel: 905-555-1515, fax: 905-555-1616. The policy is in his partner's name - Oliver Cheng, policy number JK3Y48361. Oliver did not purchase additional optional benefits. Able Insurance assigned claim number 826394869 to the file. The adjuster is Chanelle Sidhu (telephone ext: 204, email.) Able Insurance sent Stephan the Application for Accident Benefits (OCF-1) form which he completed on his own and sent to Chanelle Sidhu on August 23, 2022 along with the Treatment Confirmation Form (OCF-23). At Able Insurance's request, he also had a Disability Certificate (OCF-3) completed by his doctor, Dr. Malik, and submitted it by the date requested.

Stephan works as an auto mechanic and although he was in good physical condition before the accident, the injuries prevented him from returning to work. He spent several weeks at home recuperating and attending physiotherapy twice a week with Lily Fernandez, a physiotherapist. He tried to return to work part-time in early October but was not able to do so. He told Chanelle Sidhu that he had tried returning to work without success.

In January, Chanelle Sidhu called Stephan and asked him to submit an updated medical report of his condition. He went to his doctor, Dr. Malik, who provided a report indicating that Stephan continued to suffer the effects of the concussion (he was experiencing migraines which he did not experience prior to the accident), difficulty concentrating, memory lapses, soft tissue injury and broken ribs but that the whiplash and herniated disc were beginning to show improvement and he needed to continue physiotherapy. Able Insurance interpreted the report to mean that Stephan was no longer "unable to perform the essential tasks of employment". He received a letter on January 23, 2023 indicating that his income replacement and medical benefits would be terminated effective January 30, 2023. He called Chanelle Sidhu and asked if Able Insurance was prepared to reconsider the decision and was told no. Ms. Sidhu did not ask Stephan to go for a further medical examination but he visited Dr. Malik again on February 16, 2023 who confirmed by letter that his injuries had not healed sufficiently to return to work. The internal resolution process at Able Insurance confirmed the termination of benefits as of January 30, 2023.

Stephan has retained Sheridan Paralegal Services to appeal the termination of benefits. He has brought you the following documents to support the appeal:

1. Credit Valley Hospital records dated July 31, 2022 to August 4, 2022

2. Dr. Malik reports dated August 12, 2022, October 17, 2022, January 12, 2023 and February 17, 2023

3. Lily Fernandez, physiotherapist, reports and receipts dated September 6, 2022 to January 23, 2023

4. Income tax return for 2020 and 2021

5. Last pay slip before the accident dated July 29, 2022

Stephan does not have a summary of benefits paid by Able Insurance Company which you will need to request from Able as it is a key document which you will rely on at the hearing of the appeal. He had been receiving $400/week in income replacement since August 8, 2022 and had his two physiotherapy visits covered in full valued at $120/week. Able Insurance has paid out $1,920.00 for physiotherapy between September 6, 2022 and January 23, 2023. He stopped physiotherapy as he couldn't afford to pay it on his own and his employer doesn't offer health benefits. There is no dispute that the injuries do fall within the Minor Injury Guidelines (MIG).

Stephan lives at Unit 12 - 7395 Lilac Crescent, Mississauga, Ontario L1L 1L1. His date of birth is January 1, 1982. His preferred language of communication is English and he wishes to communicate by email . His telephone number is 905-555-1212. He is not mentally incapable. He will be the only witness at the hearing and does not require any accommodation to participate in a hearing.

Prepare the following documents:

1. Application by an Injured Person form found on Tribunals Ontario Website

2. a letter to Able Insurance Company serving the application

3. a Certificate of Service of the application on Able Insurance Found on Tribuanls Ontario Website

4. a letter to the LAT filing all necessary material

You will not be able to "sign" the form; however, you must indicate the names of the individuals who would be signing and the date in the correct field. The application would be signed by Stephan and yourself as his representative on February 27, 2023. You will serve it by regular mail and you will prepare the certificate of service on February 27, 2023. The application fee will be paid by bank draft as you will be mailing it to the LAT.

Answer rating: 100% (QA)

Application by an Injured Person Form Insert address of the License Appeal Tribunal Application No In the matter of the Statutory Accident Benefits Schedule Accidents on or After June 1 2016 And in th... View the full answer