An accident benefits insurer must consider retroactive attendant care claims advanced in an Assessment of Attendant Care Needs (Form 1) that is submitted to the insurer. In Kelly v. Guarantee Company of North America (“Guarantee Company”), this issue was recently decided by Arbitrator John Wilson in favour of the insured, where the Guarantee Company argued that it was not required to pay attendant care expenses incurred prior to the submission of a retroactive Form 1. The decision is important, as unrepresented and seriously injured accident victims who are in need of attendant care services are frequently unable to comply with the technical requirements for claiming attendant care expenses under the Statutory Accident Benefits Schedule (SABS). In Kelly, the applicant, Stephanie Kelly, suffered a severe brain injury in a motor vehicle accident on April 6, 2009, from which she was found to be catastrophically impaired. Following the accident, Ms. Kelly was transferred to ...
Also in this Issue
LOOSE LIPS CAN SINK SHIPS: WAIVER OF PRIVILEGE
- Robert M. Ben
CATASTROPHIC IMPAIRMENTS BY VIRTUE OF MENTAL AND BEHAVIOURAL DISORDERS
- Michael L. Bennett
On December 6, 2017, Adjudicator Go confirmed that an insured is entitled to be paid attendant care benefit regardless of whether the ... Continue
To receive Thomson Rogers’ newsletter the Accident Benefit Reporter, and information on upcoming conferences and events, please provide us with your name and email below. You can unsubscribe at any time.