Serious burn cases, by virtue of the impact these injuries can have on many bodily systems and functions, may require health care professionals to come up with creative recommendations to maximize the patient’s reintegration into former lifestyles and vocations. Under Bill 59, the insurer is required to pay for all reasonable and necessary measures that reduce the effects of any disability and assist in the injured person’s reintegration into family, society and employment. As illustrated by the case below, this may allow health care professionals considerable leeway in devising innovative solutions to better serve the rehabilitation needs of burn victims.In an arbitration decision decided in 1998 (see Zettler v. Pilot Insurance Co.,  O.I.C.D.No. 52), the arbitrator considered what the insurer’s obligations were to Mr. Zettler, a farmer who had sustained serious burns, among other injuries, in a motor vehicle accident. While this case was concerned with a claim under ...
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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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