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N.S. v. Scottish & York (17-007962)

  • November 26, 2019

The insurer sought reconsideration of the Tribunal’s decision that it had to fund a catastrophic impairment assessment over and above the $50,000 medical/rehabilitation limit for those with non-catastrophic injuries. Vice-Chair Flude confirmed the Tribunal’s decision, finding that the Tribunal did not make any significant error of law. Section 18(5) of the SABS provides that assessments are included in the applicable monetary limits when conducted “in connection with any benefit or payment”. Relying on his own decision in J.M. v. Aviva, Vice Chair Flude held that catastrophic impairment is a designation, not a benefit. As such, he held that catastrophic impairment assessments are not caught by section 18(5) and must be funded over and above the $50,000 medical/rehabilitation limit.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, CAT Assessments, Reconsideration
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