Case Summary: Household and attendant care expenses must be incurred to be recovered under the Ontario Statutory Accident Benefit Schedule
Insurance law – Automobile insurance – Statutory Accident Benefits Schedule – Benefits – Attendant care – Practice – Leave to appeal – New trial
Pucci v. Wawanesa Mutual Insurance Co.,  O.J. No. 1758, 2020 ONCA 265, Ontario Court of Appeal, April 24, 2020, D.H. Doherty, D.M. Brown and J.A. Thorburn JJ.A.
The insured brought a claim against her insurer for payment of accident benefits arising out of a motor-vehicle accident. At trial the issue was whether her catastrophic impairment, which was due to a psychiatric disorder, was a direct result of the motor-vehicle accident. Consequently, the trial judge awarded income replacement, housekeeping, and attendant care benefits.
The insurer appealed the award of housekeeping and attendant care benefits on the basis that there was no evidence the expenses had been incurred by the insured.
The Court of Appeal allowed the appeal finding the trial judge erred in holding the expenses had been incurred. As a result, the Court of Appeal ordered a new trial to determine whether the payment of the expenses was unreasonably withheld by the insurer.
This case was digested by Cameron B. Elder, and first published in the LexisNexis® Harper Grey Insurance Law Netletter and the Harper Grey Insurance Law Newsletter. If you would like to discuss this case further, please contact Cameron B. Elder at firstname.lastname@example.org.