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The Applicant by his Guardian, K. R. v. Unifund Assurance Company (18-001975)

  • April 18, 2019

The claimant was catastrophically impaired in a motor vehicle accident in August 2017, and remained in a coma until the date of his death on September 11, 2018. The claimant claimed for legal fees incurred in obtaining a guardianship order, arguing that the legal fees were a rehabilitative benefit. The respondent argued that the legal fees were not goods and services, and further denied liability based on the claimant’s failure to submit and treatment plan in advance of incurring the expense. Adjudicator Fricot concluded that the claimant was not entitled to payment for the legal fees incurred in obtaining a guardianship order. She noted that irrespective of whether the expense was a rehabilitation expense, the claimant did not submit a treatment plan in advance of incurring the legal costs associated with obtaining the guardianship order. As such, the respondent was not liable to pay those costs.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Catastrophic Impairment
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