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J.N. v Co-Operators General Insurance Company (18-012227)

  • April 9, 2020

The claimant submitted a LAT Application in August 2017 disputing attendant care benefits, among other benefits. The parties resolved the issues in dispute and entered into a partial settlement agreement. In 2018, the claimant filed a second LAT Application disputing entitlement to attendant care benefits. The insurer brought this preliminary issue hearing, arguing that the claimant was barred from pursuing his claim for attendant care benefits in this 2018 Application as a result of the release and partial settlement disclosure notice arising from the 2017 Application. The claimant argued that he did not settle his entitlement to attendant care benefits beyond two years from the date of the accident, and thus, the settlement following the 2017 Application did not preclude him from proceeding with the 2018 Application. Vice Chair Marzinotto did not accept the claimant’s argument, noting that the 2017 Application indicated that the claimant was claiming attendant care benefits on an “ongoing” basis and that the settlement documents clearly referred to “any and all claims for attendant care benefits from July 5, 2016 to date and ongoing”. As such, Vice Chair Marzinotto dismissed the application.

Full decision here

TGP Analysis

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  • FILED UNDER Attendant Care Benefits, Settlement
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