The claimant applied to the LAT seeking entitlement to attendant care benefits, rehabilitation benefits, and a special award. The claim for ACBs was made for two distinct periods. The LAT found the claimant was not entitled to ACBs for the first period claimed as the benefits had not been incurred. The LAT did not accept that the claimant did not receive proper notice that ACBs had been approved and declined to deem the expenses to have been incurred. The approval had been sent to the claimant by letter, which was also faxed to the claimant’s counsel. The claimant was entitled to the disputed rehabilitation benefits and ACBs for the second period claimed. A special award was granted. The LAT found the insurer gave unreasonable weight to s. 44 opinions (compared to other medicolegal reports and the records of treating practitioners) when denying ACBs and life skills training. The LAT found the insurer’s decision was unreasonable and lacked transparency.
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