Scott Puddicombe

The applicant, catastrophically impaired following a bus-train collision, sought statutory accident benefits for home modifications, the purchase of a new home, and housekeeping services.

The Tribunal deemed the $166,437.70 home modification expense incurred under s. 3(8) of the Schedule due to the insurer's unreasonable delay and flawed reliance on its assessors, awarding a 25% special award.

The request for $839,104.50 to purchase a new home was dismissed as it exceeded the value of necessary home modifications under s. 16(4)(c).

Housekeeping benefits of $100 per week were granted from February 2019 onwards.

The insurer was found entitled to repayment of an $8,747.42 overpayment of income replacement benefits resulting from a failure to recalculate the benefit when the applicant turned 65.

The applicants, who both required leg amputations following a motorcycle accident, sought funding for home modifications under the Statutory Accident Benefits Schedule.

The parties presented competing modification plans, with the applicants proposing a one-storey expansion and the respondent proposing a two-storey build.

The adjudicator found the applicants' plan to be reasonable and necessary, as it accommodated their wheelchair needs while preserving their pre-accident lifestyle and avoiding the safety risks of a two-storey design.

The adjudicator also awarded the applicants 25% of the value of a back-up generator under section 10 of Regulation 664, finding that the respondent unreasonably delayed its approval.