Introduction

The Licence Appeal Tribunal does not often order an insurer to pay denied attendant care benefits outright. When it does, clinics and caregivers should pay attention to what made the difference.

A 2026 decision, [[N] v Definity Insurance Company, 2026 CanLII 48381 (ON LAT)](https://canlii.ca/t/kl3gh), did exactly that. The Tribunal ordered the insurer to pay denied attendant care benefits of up to $1,200. The decision reinforces a pattern that runs through every 2026 billing and care decision at the LAT: contemporaneous, detailed documentation wins. Vague or retroactive records lose.

What Happened

The claimant sought attendant care benefits that Definity had denied, but the outcome is the Tribunal reviewed the evidence and ordered the insurer to pay.

What This Means for Attendant Care Providers

The Definity decision does not break new ground legally, but it adds weight to the documentation standards that the 2026 LAT expects:

1. Daily logs are the minimum.

A weekly summary is not enough. A monthly estimate is not enough. The Tribunal wants to see day-by-day records showing what service was provided, when, for how long, and by whom.

2. Form 1 is an assessment tool, not a billing document.

As the S.K. v. Aviva decision established, Form 1 rates are for calculating monthly entitlement. They are not caps on what providers can charge. And the Form 1 itself is not a substitute for contemporaneous care logs. Using it as the basis for invoice preparation is exactly what the Tribunal scrutinizes.

How to Strengthen Your Attendant Care Claims

If your clinic or your patients' caregivers are submitting attendant care invoices, here is what the 2026 decisions collectively tell you to do:

  • Log daily, not weekly or monthly
  • Include start time, end time, service description, and provider signature
  • Attach clinical records that document the impairment creating the need for care
  • Submit the log with the invoice - do not wait for the insurer to request it
  • If your rate is above Form 1 levels, provide market evidence to justify it

Conclusion

The Definity decision is not the most detailed ruling of 2026, but it is part of a clear and consistent pattern. The Tribunal will order attendant care paid when the documentation supports it. The burden is on the provider and the claimant to create that documentation - contemporaneously, specifically, and with clinical support.