P.W. v. Aviva Insurance Canada (18-000854)

In an April 2020 decision, the Tribunal found that the claimant was entitled to an attendant care assessment based on an argument that was not raised by either party. The insurer’s request for reconsideration was granted, and the issue was re-heard. Adjudicator Gosio found that the attendant care assessment at issue met the requirements of section 25(1)4 of the SABS, which requires the insurer to pay for an attendant care assessment if it is completed by an occupational therapist or registered nurse, the fee charged was reasonable, and the fee was incurred. As such, he concluded that the claimant was entitled to the attendant care assessment.