Assessments Payable, Even Though Medical And Rehabilitation Limits Were Exhausted

On May 4, 2015, Director's Delegate Blackman released his decision in Cook and RBC^[1], which deals with the payment of catastrophic ("CAT") assessments under the Statutory Accident Benefits Schedule—Effective September 1, 2010^[2] ("2010 SABS").

In this case, the Applicant brought a Motion for an Order that the Insurer pay him $12,960.00 for CAT assessments. Arbitrator Mutch found that the funding of a rebuttal CAT assessment was most properly characterized as an interim expense rather than an interim benefit. Although an award of interim expenses of at least some of the claimed expense was warranted, Arbitrator Mutch found that he was prevented from ordering payment by Sections 18(3) and 18(5) of the 2010 SABS. Subsection 18(5) placed the Applicant under the $50,000.00 cap for both treatment and assessments in non-catastrophic cases, which had been exhausted.