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K.T. v. Aviva General Insurance (17-007027)

  • July 19, 2018

The claimant sought entitlement to attendant care benefits beyond the termination date despite no amounts being incurred. The claimant asked that the LAT deem the expenses incurred. Adjudicator Mazerolle concluded that he could not deem the expenses incurred. He held that the insurer’s termination of attendant care benefits was not unreasonable and that the IE report that supported the termination was based on appropriate factors. Further, the claimant had not promised to pay for any attendant care services beyond the date of termination.

Full decision here

TGP Analysis

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  • FILED UNDER Attendant Care Benefits, Incurred Expense
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