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Balachandran v. Economical Insurance (21-014940)

  • December 21, 2022

The claimant applied to the LAT in order to dispute the hourly rates for ACBs being prescribed by his insurer. Adjudicator Kaur found that the LAT did not have jurisdiction to rule on the matter because there was no dispute regarding the claimant’s eligibility to a benefit under the SABS. The amount being claimed in his Form 1 for ACBs was approved by the insurer. The insurer requested that the claimant submit an expense claim so that he could be compensated for his out-of-pocket expenses for ACBs. The claimant argued that the LAT possessed jurisdiction as the insurer had reportedly disputed the hourly rate at which ACBs were to be paid. Adjudicator Kaur ruled that the LAT did not have jurisdiction to hear the application because neither the claimant’s entitlement to ACBs, nor the amount of the ACB being approved was in dispute. The claimant’s application was dismissed.

Full decision here

TGP Analysis

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  • FILED UNDER Attendant Care Benefits, Jurisdiction
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