The applicant was injured in a motor vehicle accident and sought attendant care benefits (ACBs) from the respondent insurer.
The parties had previously executed a settlement agreement fixing the monthly ACB amount at $1,200.00.
The respondent partially denied subsequent invoices, arguing its liability was strictly capped by the maximum hourly rates in the Superintendent's Guideline.
The Tribunal found that the 2018 Guideline uses hourly rates to calculate the monthly benefit but does not strictly cap the insurer's liability on a per-invoice basis once the monthly amount is fixed.
The Tribunal ordered the respondent to pay the incurred ACBs up to the $1,200.00 monthly limit, plus interest, but declined to order an award under s. 10 of Reg. 664.
