Ms. Ghatas

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and assessment costs following a motorcycle accident.

The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment under either criterion 7 or 8, preferring the evidence of the respondent's experts over the applicant's expert, whose conclusions relied heavily on inconsistent self-reporting.

The Tribunal also dismissed the claims for attendant care benefits and assessment costs due to a lack of evidence demonstrating incurred expenses or reasonable necessity.

The Co-operators General Insurance Company brought a motion to compel the plaintiff, Annette Brooks, to attend a second independent medical examination with a physiatrist.

The plaintiff opposed, offering to withdraw her own physiatry report.

The court granted the motion, finding that the examination was warranted to ensure a fair determination of the nature and extent of the plaintiff's injuries, despite the plaintiff's offer and the late stage of litigation, as the plaintiff's physiatry report was relied upon by another expert and the proposed examination was not duplicative.

The insurer requested a reconsideration of a Tribunal decision that awarded the insured up to $6,000 per month in attendant care benefits and a 25% special award under section 10 of O. Reg. 664.

The reconsideration adjudicator granted the request, finding that the first-instance Tribunal erred in law by failing to calculate the attendant care benefits using the mandatory hourly rates prescribed by the Guideline.

The adjudicator recalculated the incurred attendant care based on a ratio derived from the occupational therapist's recommendations.

Furthermore, the adjudicator set aside the 25% special award, concluding that the insurer's conduct in relying on its own experts' reports to partially approve benefits was not excessive, imprudent, or inflexible, and did not meet the threshold for an unreasonable withholding or delay of benefits.