The applicant sustained a catastrophic brain injury in a motor vehicle accident and applied for statutory accident benefits.
The arbitrator held that the applicant was not entitled to care benefits in excess of the $3,000 monthly limit under section 7 of the Schedule, as the services provided by his family were 'care' rather than 'nursing' services.
However, the arbitrator found that the applicant's current inaccessible apartment was impeding his rehabilitation and ordered the insurer to provide rehabilitation benefits for accommodation with specific accessibility features, noting that purchasing and renovating a house was a reasonable option under section 6.
The arbitrator also granted a special award of $3,000 due to the insurer's unreasonable delay in paying certain medical and rehabilitation benefits.
