Ann Fitzhenry Bedard

The applicant, who sustained a catastrophic brain injury in a motor vehicle accident, sought interim attendant care benefits.

The insurer denied the benefits, arguing his needs were met by the long-term care facility where he resided.

The arbitrator found the applicant established a prima facie case for entitlement and demonstrated urgency and risk of irreparable harm due to the likelihood of another seizure and the facility's staff-to-patient ratio.

The arbitrator ordered the insurer to pay past and ongoing interim attendant care benefits, plus interest, and ruled that the facility's co-payment for accommodation and meals is a medical benefit, not deductible from attendant care benefits.

The applicant, who suffered a moderate brain injury in a pedestrian motor vehicle collision, sought interim attendant care benefits after the insurer terminated them.

The insurer relied on a Designated Assessment Centre (DAC) report suggesting the applicant's need for supervision pre-dated the accident due to ADHD.

The arbitrator found significant flaws in the DAC report, including procedural irregularities and a failure to consider whether the accident exacerbated pre-existing vulnerabilities.

Finding that the applicant established a compelling prima facie case for entitlement and urgency due to safety risks, the arbitrator ordered the insurer to pay interim attendant care benefits pending a full arbitration hearing.

The Applicant was injured in a motor vehicle accident and received statutory accident benefits until the Insurer terminated them.

The Applicant applied for arbitration to reinstate weekly benefits, claim medical and rehabilitation expenses, and seek a special award.

The Arbitrator found no jurisdiction to determine the medical and rehabilitation benefits as they were not raised at mediation.

The Arbitrator held that the Applicant was substantially unable to perform her pre-accident essential tasks until the 156-week mark, entitling her to weekly benefits until December 12, 1994.

The claim for a special award was dismissed because the Insurer's termination of benefits, while incorrect, was not arbitrary or capricious.