Applicant v. The Dominion of Canada General Insurance Company(18-002185)

The claimant sought a determination that the HST paid with respect to the attendant care services provided should be paid outside of the attendant care benefit limit, and a special award for unreasonably withholding payments of the attendant care benefit by paying HST out of the benefit limit. Adjudicator Gosio was persuaded by the claimant’s submissions, and found that HST should be paid outside of the attendant care benefit limits. However, Adjudicator Gosio concluded that the insurer had not unreasonably withheld payment of the attendant care benefit, as both the SABS and the mandatory FSCO Guidelines were silent with respect to the handling of HST in the attendant care benefit context, and thus the insurer’s interpretation of its obligations was not so unreasonable as to warrant an award.