Hathaway-Warner v. TD General Insurance Company
Licence Appeal Tribunal File Number: 23-005315/AABS
In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.
Between:
Valerie Hathaway-Warner
Applicant
and
TD General Insurance Company
Respondent
DECISION
ADJUDICATOR: Roderick Walker
APPEARANCES:
For the Applicant: Sherilyn Pickering, Counsel
For the Respondent: Sean Cheskes, Counsel
HEARD: By Way of Written Submissions
OVERVIEW
1Valerie Hathaway-Warner, the applicant, was involved in an automobile accident on July 14, 2010, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Accidents on or after November 1, 1996 (the “Schedule”). The applicant was denied benefits by the respondent, TD General Insurance Company, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
ISSUES
2The issues in dispute are:
i. Is the applicant entitled to $927.60 for an occupational therapy device proposed by Personal Injury Occupational Therapy (PiOT) Inc. in a treatment plan/OCF-18 ("plan”) submitted May 17, 2021, and denied May 27, 2021?
ii. Is the respondent liable to pay an award under s. 10 of Reg 664 because it unreasonably withheld or delayed payment to the Applicant?
iii. Is the applicant entitled to interest on overdue payment of benefits?
RESULT
3I find that the applicant is entitled to the treatment plan for an occupational therapy device proposed by Personal Injury Occupational Therapy (PiOT) Inc