RECONSIDERATION DECISION
Before:
Christopher Evans
Licence Appeal Tribunal File Number:
21-006478/AABS
Case Name:
Sandra Pettifer v. Aviva Insurance Canada
Written Submissions by:
For the Applicant:
Ryan Jeffries, Paralegal
Jessica Friend, Paralegal
For the Respondent:
Michael McChesney, Counsel
OVERVIEW
1The applicant requests reconsideration of the Tribunal’s decision dated November 22, 2023, in which I found she was entitled to attendant care benefits of $2,820.16 with interest. She submits that I erred in finding she only incurred attendant care expenses between March 6 and May 26, 2021 rather than between May 7, 2020 and August 4, 2021. She requests that the decision be varied to provide that she is entitled to $20,032.84 with interest, or, in the alternative, $15,040.80 with interest.
RESULT
2The request for reconsideration is dismissed.
ANALYSIS
3The applicant requests reconsideration under Rule 18.2(b) of the Licence Appeal Tribunal Rules, 2023 on the grounds that I made an error of law or fact absent which I would likely have reached a different result.
4The respondent paid attendant care benefits up to January 7, 2021, when it terminated the benefit after commissioning insurer’s examinations. The applicant submitted three invoices totalling $7,400.32 for attendant care expenses incurred from March 6 to May 26, 2021. The respondent refused to pay for them because it had determined that she was no longer entitled to attendant care benefits. At issue was whether she was entitled to benefits for those three invoices. I found that she was entitled to an attendant care benefit of $940.05 per month, and that she was therefore entitled to $2,820.16 for the three months in dispute.
5In the reconsideration request, the applicant argued that I erred in finding she incurred attendant care expenses for only three months when the evidence showed that she incurred them for sixteen months from May 7, 2020 to August 4, 2021. The respondent noted that only three months of attendant care benefits were in dispute. In reply, the applicant conceded that her entitlement to the expenses incurred from March 6 to May 26, 2021 was the issue put before me. She argues that I should now consider her entitlement to expenses incurred from May 7, 2020 to August 4, 2021 for the following reasons:
a. The respondent seeks to take advantage of her previous representative’s error in stating the date range at issue;
b. The respondent categorically denied that she was entitled to an attendant care benefit and did not focus exclusively on the March 6 to May 26, 2021 time period;
c. The overarching principle ought to be that the right decision is reached;
d. I considered the medical evidence relating to the broader time period;
e. Denying the reconsideration request would force her to file another application for the broader time period;
f. Rule 3.2 permits the Tribunal to make such orders or give such directions in proceedings before it to control its process; and
g. Denying the reconsideration request would be inconsistent with the requirement that the Rules be interpreted liberally and the consumer protection purpose of the Statutory Accident Benefits Schedule.
6I find that I did not make an error in my decision. I did not find that the applicant only incurred attendant care expenses between March 6 and May 26, 2021. The issue before me was whether she was entitled to the expenses incurred during that period. I made no finding as to whether she incurred attendant care expenses before or after. It was unnecessary to do so because those other expenses were not in dispute.
7The applicant essentially asks me to consider a new dispute regarding her entitlement to statutory accident benefits. I do not have jurisdiction to do. Rule 18.1 provides that the Tribunal may reconsider any decision that finally disposes of an appeal. It does not empower the Tribunal to consider a dispute that was not before it in the decision under reconsideration. Rule 3.2 provides that the Tribunal may make orders or give directions to control its process or to prevent abuse of its process. Deciding a new dispute on reconsideration is not a procedural order or direction.
8I conclude that the applicant has not established that one or more of the criteria for granting reconsideration under Rule 18.2 are met.
ORDER
9The request for reconsideration is dismissed.
Christopher Evans
Adjudicator
Tribunals Ontario – Licence Appeal Tribunal
Released: March 8, 2024