“In deciding whether the words in s. 19 are subject to two plausible interpretations and therefore ambiguous, the words regarding payment for attendant care benefits must be read in the context of the SABS regulation as a whole,” Justice Mary Lou Benotto wrote.
The court noted that ss. 14 and 19 of the SABS both establish the statutory basis upon which an insurer is obliged to pay for an insured’s attendant care. Section 14 imposes liability on the insurer to pay attendant care benefits to an insured who sustains a non-minor impairment as a result of an accident.
Meanwhile, s. 19(1) states that the attendant care benefits are the “reasonable and necessary” expenses incurred by an insured for services provided by an aide or attendant, a long-term care facility, or a chronic care hospital. In addition, s. 19(3) imposes $6,000 and $1,000,000 limits to…
