The claimant was involved in an accident in 2014. The insurer determined that she was catastrophically impaired in 2018. The claimant received attendant care services from a hired attendant care services provider for the period of July 2014 to March 2020. Due to the COVID pandemic, after March 2020 the claimant’s family decided to have the claimant monitored by her son rather than a paid attendant care services provider. Until the fall of 2020, the insurer took the position that the claimant was barred by the limitation period from receiving payment for ACBs. In September 2020, following the reversal of its legal position following the Court of Appeal’s reasons in Tomec v Economical, the insurer paid the amount of ACBs incurred from July 2014 to March 2020, plus interest. The amount incurred and paid was less than the maximum amount of $6,000.00 per month available to catastrophically impaired persons. The claimant applied to the LAT seeking entitlement to ACBs in the amount of $6,000 per month from May 2016 to date. The argued that additional amounts for ACBs up to $6,000 should be deemed incurred to date or until March 2020, if the claimant’s son was found not to have suffered an economic loss. Adjudicator Farlam found that there was no basis for finding that the insurer unreasonably withheld or delayed payment of ACBs and declined to deem that ACBs had been incurred, pursuant to section 3(8) of the SABS. The claimant failed to demonstrate that her son suffered any economic loss in providing alleged attendant care services. Adjudicator Farlam also held that the insurer did not act unreasonably by denying ACBs based on the limitation period, prior to the release of Tomec v. Economical. Once the decision was released, the insurer paid the claimant the incurred ACBs plus interest.
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