Insurers cannot escape paying less than the Form 1 rate

Posted January 4, 2013

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With the return of the definition for the term “incurred”, Insurers have been applying various interpretations of this term in order to reduce or limit the amount of attendant care payable since September 1, 2010.

Recently, FSCO released a decision with respect to an Insurer’s attempt to pay the attendant care benefit based on the minimum wage applicable to the Insured’s residency rather than the Form 1 hourly rate. While this decision relates to a collision, which predates the September 1, 2010 changes, the Arbitrator makes it clear that the Insurer must pay basic supervisory attendant care at the Form 1 rate of $7.75 per hour.

On June 14, 2006, Costel Sicoe sustained catastrophic injuries in a motor vehicle collision. Jevco initially paid Mr. Sicoe a monthly attendant care benefit at the rate of $6,000 per month in accordance with the Form 1. Three years later, Mr. Sicoe moved back to Romania where his parents provided him with 24-hour basic supervisory care.

In response, Jevco reduced Mr. Sicoe’s attendant care benefit to $1,596.10 per month based on the fact that the minimum wage in Romania is $1.30 per hour compared to the rate of $7.75 per hour as set out in the Form 1.

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