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 ...
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On December 6, 2017, Adjudicator Go confirmed that an insured is entitled to be paid attendant care benefit regardless of whether the ... Continue
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