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Applicant found catastrophically impaired under Criterion 8 but denied non-earner, attendant care, and treatment benefits.
The applicant sought statutory accident benefits following a 2021 motor vehicle accident.
The Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 due to marked impairments in all four areas of function (activities of daily living, social functioning, concentration, persistence and pace, and adaptation) stemming from accident-related mental and behavioural disorders, including somatic symptom disorder and exacerbated PTSD.
However, the Tribunal dismissed the claims for a non-earner benefit, attendant care benefits, and various treatment plans, finding the applicant did not suffer a complete inability to carry on a normal life and failed to prove the treatment plans were reasonable and necessary.
Attendant care benefits awarded at $1,879.82 per month; provider mileage expenses denied as unauthorized.
The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits and payment for various treatment plans.
The Licence Appeal Tribunal found the applicant was entitled to attendant care benefits of $1,879.82 per month, rejecting both the applicant's claim for $6,000 and the insurer's approval of $715.88.
The Tribunal denied the treatment plan for physio/vestibular services because it was not submitted through the HCAI system.
The Tribunal also denied the disputed amounts for occupational therapy and social work services, finding the insurer's approved hourly rate for the social worker was appropriate and that mileage expenses for treatment providers to travel to the applicant's home were not authorized transportation expenses under the Schedule.
The court ruled the plaintiff met the statutory threshold for general damages due to severe, permanent psychological impairments caused by a motor vehicle accident.
This decision concerns a threshold motion following a jury trial for damages arising from a motor vehicle accident.
The court was required to determine whether the plaintiff, Carissa Marcantonio, suffered a "permanent serious impairment of an important physical, mental or psychological function" as defined by the Insurance Act.
After reviewing the evidence of the plaintiff, her family, friends, treating professionals, and expert witnesses, the court found that the plaintiff suffered a severe, permanent impairment of an important mental or psychological function as a result of the accident, entitling her to general damages as awarded by the jury.
