Sean Allen

The applicant, who was struck by a car while riding his bicycle, sought $2,200 for an occupational therapy assessment and attendant care needs evaluation under the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal dismissed the application, finding insufficient evidence that the treatment plan was reasonable and necessary.

The Tribunal preferred the insurer's medical evidence, noting the applicant's complex pre-existing medical history and a lack of contemporaneous medical records supporting accident-related functional impairments.

The Applicant was catastrophically injured in a motor vehicle accident and sought attendant care benefits under the Statutory Accident Benefits Schedule.

The Insurer denied the benefits, arguing they were not "incurred" because the Applicant's caregivers did not sustain an economic loss.

The arbitrator found that the Applicant's friend, who housed and cared for him while acting as his surety on bail, sustained an economic loss by charging reduced rent and incurring additional grocery and utility costs.

The arbitrator awarded attendant care benefits of $3,526.34 per month for the period the Applicant resided with this friend.

Claims for other periods, including while the Applicant was hospitalized, staying with other family members, or incarcerated, were dismissed due to a lack of evidence of attendant care services provided or economic loss sustained.