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Verschuren v. the Personal Insurance Company (20-003677)

  • January 14, 2021

The claimant was involved in a serios motorcycle accident and was determined to be catastrophically impaired by the insurer. The claimant submitted a treatment plan for a home modification assessment by Adapt-Able Design in the amount of $9,217.40. The insurer partially approved the assessment in the amount of $2,200. The claimant applied to the LAT seeking entitlement to the denied portion of the treatment plan. Adjudicator Boyce was persuaded by the reasoning in previous LAT decisions with similar facts, and found that the insurer was not obligated to pay more than $2,000 for the proposed assessment, pursuant to section 25(5)(a). The claimant was not entitled to the unapproved portion of the treatment plan.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Home Modification
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