Insurer ordered to pay increased attendant care benefits and a special award for unreasonable denials.
The applicant was injured in a motor vehicle accident and sought attendant care benefits (ACB) and a special award from her insurer.
The insurer had previously conceded catastrophic impairment and entitlement to some benefits but disputed the quantum of ACB and the special award.
The arbitrator found the applicant's occupational therapist's evidence to be reasonable and holistic, awarding ACB of $1,728.19 and $2,593.67 per month for the respective periods.
The arbitrator also found the insurer's conduct in relying on flawed assessments and ignoring cognitive issues to be unreasonable, thereby meeting the threshold for a special award.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesJul 27, 2018
