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Attendant care benefits partially granted for daytime needs; nighttime supervision and special award denied.
The applicant, who sustained a catastrophic impairment in a motor vehicle accident, sought attendant care benefits (ACB) of $4,339.71 per month and assistive devices.
The respondent insurer had reduced her ACB to $1,040.10 per month.
The Tribunal found that the applicant's claim was not statute-barred because the insurer failed to provide proper medical reasons for its refusal, meaning the limitation period had not commenced.
On the merits, the Tribunal accepted the applicant's need for daytime cueing and mobility assistance but rejected the need for nighttime supervisory care, awarding ACB at $1,630.72 per month.
The Tribunal declined to deem the expenses incurred, as the insurer had paid all submitted invoices and did not unreasonably delay payment.
Claims for assistive baby devices and a special award under Regulation 664 were dismissed.
The court approved a minor's accident benefits settlement but drastically reduced the requested solicitor-client fees due to a non-compliant contingency fee agreement.
The applicant, a minor by his litigation guardian, sought court approval for a $1,450,000 accident benefits settlement with Intact Insurance, a structured settlement, and solicitor-client fees of $293,800, along with a contingency fee agreement.
The court approved the settlement as fair and reasonable but found the contingency fee agreement non-compliant with regulations and reduced the solicitor-client fees to $145,000 plus HST, citing numerous errors and inconsistencies in counsel's filings and time dockets.