Lisa Martin

The minor applicant was struck by a dump truck while in a stroller in 2010.

He sought statutory accident benefits for various treatment plans, which the respondent insurer denied based on insurer examinations.

The Licence Appeal Tribunal found the applicant was entitled to optometric services, speech language therapy, and certain assistive devices (a curved monitor and wobble stool), preferring the evidence of the applicant's treating practitioners over the respondent's paper reviews.

However, the Tribunal denied funding for a gaming computer and a YMCA summer camp/membership, finding them not reasonable and necessary.

Interest was awarded on the overdue benefits.

The applicant sustained catastrophic injuries, including a traumatic brain injury, in a motor vehicle accident.

A dispute arose regarding the quantum of attendant care benefits under section 16 of the Statutory Accident Benefits Schedule.

The insurer reduced benefits from $6,000 to $2,132 per month, arguing the applicant's increased needs were due to post-accident drug abuse and traffic charges rather than the accident.

The arbitrator found the drug abuse was caused by the accident and that the applicant required 24-hour supervision until his rehabilitation stabilized in early 2011.

The applicant was awarded $6,000 per month for the disputed period up to March 2011, and $2,132 per month ongoing thereafter.