M.F. v. Allstate Insurance Company (17-001328)

The claimant sought entitlement to the cost of an attendant care assessment and interest. Adjudicator Kowal dismissed the claimant’s application as the claimant had not incurred the cost of the attendant care assessment. However, Adjudicator Kowal held that in order for an initial s. 25 attendant care assessment to be found payable, five criteria must be met: (1) the claimant’s injuries be outside the MIG; (2) the OCF-18 for an attendant care assessment be submitted to an insurer and compliant with s. 32; (3) the attendant care assessment be incurred; (4) the attendant care assessment and Form 1 be completed by a registered nurse or occupational therapist; and (5) the fees be reasonable as per the Professional Services Fee Guidelines.