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Gichuki v TD Insurance Meloche Monnex (20-004631)

  • April 19, 2022

The claimant sought entitlement to attendant care benefits in the amount of $7,644.34, less $225.75 approved by the insurer, per month, from May 22, 2018 and ongoing. Vice Chair McGee found that attendant care benefits were not payable prior to October 31, 2019 when she submitted an Assessment of Attendant Care Needs (Form 1), pursuant to section 42(5) of the SABS. In submissions, the claimant significantly narrowed the scope of her claim, seeking payment only for her incurred expenses, equal to $220.32 per month. The attendant care services were provided by the claimant’s friend and personal support worker. Despite their friendship, Vice Chair McGee accepted that the provider qualified as a professional service provider who provided the claimant with services in the course of a profession in which she would ordinarily have been engaged but for the claimant. The timesheets provided established that the claimant received a total of 33 hours of attendant care between November 2020 and February 2021. As such, Vice Chair McGee found that the claimant was entitled to be reimbursement for 33 hours of attendant care expenses, payable at a rate of $14.00 per hour (per the Rate Guideline), for a total of $462.00, with interest.

Full decision here

TGP Analysis

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  • FILED UNDER Attendant Care Benefits, Incurred Expense
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