Attendant care benefits denied as applicant failed to prove services were received or care provider suffered economic loss.
The applicant sought attendant care benefits (ACB) following a motor vehicle accident, claiming her daughter provided 24/7 care.
The respondent insurer denied the claim on the basis that the expenses were not 'incurred' under section 3(7)(e) of the Statutory Accident Benefits Schedule.
The Tribunal found that while the applicant was legally obligated to pay for the services, she failed to prove she actually received the services as claimed, noting vague invoicing and contradictory surveillance evidence.
Furthermore, the applicant failed to demonstrate that her daughter sustained an economic loss to provide the care, as the daughter had not been actively working for years prior to the accident.
The application for ACB and interest was dismissed.
OLATOntario Licence Appeal TribunalJun 15, 2023
