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Rida v. Wawanesa Mutual Insurance Company (19-013934)

  • April 20, 2021

The claimant was declared catastrophically impaired and sought payment of attendant care benefits and housekeeping benefits provided by her daughters. The insurer ultimately accepted that the claimant was entitled to payment of the benefits, and argued that since it agreed with the claim, there was no basis upon which a special award could be granted. Adjudicator Farlam stated that there was no evidence that the benefits had in fact been paid and therefore the issue of payment and interest were still outstanding. As a result, it was open for an adjudicator to determine the special award issue. However, Adjudicator Farlam concluded that the claimant was not entitled to a special award because the insurer’s decision to retain accountants to estimate the economic loss and the request for affidavit evidence was reasonable and prudent. She also found that a delay of 21 days in issuing a cheque was not unreasonable and did not violate the Unfair or Deceptive Acts or Practices regulation.

Full decision here

TGP Analysis

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  • FILED UNDER Special Award
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