The claimant disputed her entitlement to attendant care benefits and various medical benefits. Adjudicator Paluch found that the claimant was not entitlement to attendant care for the period in dispute because she did not submit a Form 1 in accordance with the SABS nor did she demonstrate that her expenses were incurred. However, Adjudicator Paluch determined that the remaining amounts for two partially approved physiotherapy treatment plans as the respondent failed to provide medical reasons and comply with section 38(8) of the SABS. The insurer simply advised that the treatment “appeared excessive”, without providing any details or particulars of what part of the services was excessive and why.
