The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to 24/7 attendant care benefits (ACBs) at $6,000 per month due to catastrophic psychiatric impairments.
The respondent insurer approved a lower monthly amount, arguing that 24/7 care was contrary to the recommendations of hospital psychiatrists and would hinder recovery.
The Tribunal found that 24/7 supervisory care was reasonable and necessary, relying on the applicant's treating psychiatrist who noted severe suicidal ideation.
The Tribunal ordered the respondent to pay $15,120 in past incurred ACBs plus interest, but declined to deem further ACBs incurred or order a special award, finding the insurer's reliance on its assessors was not unreasonable.