1Khushbu Desai, the Applicant, was involved in an automobile accident on February 4, 2019, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The Applicant was denied benefits by Unifund Assurance Company, the Respondent, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute

ISSUES

2The issues in dispute are:

1. Is the Applicant entitled to attendant care benefits in the amount of $1,484.72 per month (for an unspecified period)?

2. Is the Applicant entitled to medical benefits in the amount of $274.34 for services recommended by Alma Rehab Inc. in an invoice dated October 28, 2020?

3. Is the Applicant entitled to medical benefits in the amount of $49.00 ($1882.06 less $1,833.05 approved) for psychological services recommended by Imperial Medical Assessments Inc. in a plan dated October 23, 2020?

4. Is the Applicant entitled to medical benefits in the amount of $2,200.00 for a virtual occupational therapy assessment recommended by Innovative OT Services in a plan dated September 16, 2020?

5. Is the Applicant entitled to medical benefits in the amount of $299.22 ($3,641.03 less $3,341.81 approved) for psychological services recommended by Imperial Medical Assessments Inc. in a plan dated July 8, 2020?

6. Is the Applicant entitled to medical benefits in the amount of $2,486.00 for a neurological assessment recommended by Imperial Medical Assessments Inc. in a plan dated February 28, 2020?

7. Is the Applicant entitled to medical benefits in the amount of $282.50 for a psychological pre-screen report recommended by Imperial Medical Assessments Inc. in a plan dated November 1, 2019?

8. Is the Applicant entitled to interest on any overdue payment of benefits?

9. Is the Respondent liable to pay an award under section 10 of Regulation 664 because it unreasonably withheld or delayed payments to the applicant?

RESULT

3The Applicant is not entitled to attendant care benefits, nor the medical benefits identified in issues 2, 3, 4, 5, or 7.

4The Applicant is entitled to medical benefits in the amount of $2,486.00 for a neurological assessment (issue 6), with interest payable in accordance with section 51 of the Schedule.

5The Applicant is entitled to an award of 10% of the cost of the neurological assessment, with interest payable in accordance with the Schedule.

ANALYSIS

Attendant Care Benefits

6The Applicant submitted a Form 1 on November 12, 2020 for attendant care benefits in the amount of $1,484.72. On November 13, 2020 the Respondent wrote to the Applicant and advised that, upon review of the medical documentation provided to date, the amount was excessive for the accident related injuries, and it was proceeding to schedule a section 44 insurer’s examination.

7The Applicant submits that the notice contravened s. 38(8) and that attendant care benefits are therefore payable per s. 38(11). However, sections 38(8) and 38(11) of the Schedule set out strict notice requirements for insurers responding to treatment plans and specific consequences if they fail to comply.

8Section 42(4) sets out the notice requirements for insurers responding to attendant care expenses. Section 44 governs notice requirements for insurer’s examinations. The Applicant made no submissions on whether the notice requirements of s. 42(4) or 44(5) were met, or the consequences if the notice does not comply. By undergoing the assessment, the Applicant waived any recourse she may have had against the respondent for failure to provide medical reasons in its notice of examination. To deem attendant care benefits payable for a breach of s. 44(5) would be to read into the Schedule a remedy that is not provided.

9The Applicant made no further submissions to support her claim for attendant care benefits, and accordingly