R. Findlay

The Applicant, who sustained a catastrophic brain injury after being struck by a car as a pedestrian at age 12, sought statutory accident benefits for massage therapy, attendant care benefits (ACBs), and housekeeping and home maintenance (HH) services.

The Tribunal found the massage therapy plans reasonable and necessary, deducting only duplicative form fees.

The Tribunal preferred the evidence of the Applicant's treating occupational therapist over the insurer's assessor, awarding ACBs at the claimed rate of $546.33 per month.

The Tribunal also found the Applicant suffered a substantial inability to perform pre-accident HH tasks, awarding HH benefits at $100 per week, subject to proof of incurred expenses.

Interest was awarded on overdue payments.

The applicant sought non-earner benefits and medical benefits following a motor vehicle accident.

The insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained a minor injury and did not suffer a complete inability to carry on a normal life.

However, because the insurer failed to comply with the notice provisions under sections 36 and 38 of the Schedule, the applicant was awarded non-earner benefits for the period of non-compliance (January 18 to April 30, 2019) and an attendant care assessment plan incurred during the period of non-compliance.

The remaining assessment plans were denied as not reasonable and necessary, and the claim for an award was dismissed.