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M.K. v. Aviva Insurance Canada (16-003909)

  • September 7, 2017

The claimant sought entitlement to attendant care benefits. The insurer resisted the application for arbitration and asserted that the determination was already decided in a previous FSCO decision. Adjudicator S.F. Mather determined that the claimant’s claim before the LAT was not the same by virtue of the dates claimed. Additionally, Adjudicator Mather ruled that the FSCO decision did not make a final determination regarding attendant care benefits in the future. Indeed, it was noted that the submission of a new Form 1 would allow the claimant to dispute the denial of the insurer.

Full decision here

TGP Analysis

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