Introduction

Can an auto insurer be required to pay for meal delivery? The Licence Appeal Tribunal said yes - but only after the claimant won on reconsideration what they lost at the initial hearing.

A 2026 Licence Appeal Tribunal reconsideration decision is a case study in how non-traditional services get approved and denied at the Tribunal. Meal delivery, transportation, home modifications - these services sit at the edge of what most clinics and claimants think of as accident benefits. They are payable when the evidence supports them. They are denied when it does not.

Here is what the decision tells you about getting non-traditional services approved.

What Happened

The claimant sought attendant care benefits plus treatment plans for three services: meal delivery, nutrition counselling, and a visual skills assessment. At the initial hearing, all three were denied.

The claimant applied for reconsideration - a high bar at the LAT, requiring evidence that the original Tribunal made a significant error of law or fact. Vice Chair Craig Mazerolle reviewed the file and found the original Tribunal had erred on two of the three claims.

Meal delivery: granted on reconsideration. The clinical evidence showed cognitive and psychological impairments from the accident that made meal preparation unsafe or impossible. The original Tribunal had overlooked this evidence. On reconsideration, the Vice Chair found the meal delivery service was reasonable and necessary given the documented impairments.

Attendant care benefits: granted on reconsideration. The original denial was also reversed for attendant care, based on similar reasoning - the clinical evidence supported the need, and the original Tribunal had not adequately considered it.

Visual skills assessment: denied. Unlike the other two claims, the evidence for the visual skills assessment did not meet the threshold. The reconsideration upheld the denial on this point.

What Makes a Non-Traditional Service Payable

The decision illustrates the three-part test that the Tribunal applies to services outside standard treatment categories:

1. Clinical evidence of impairment.

You cannot simply assert that meal delivery is needed. You need clinical documentation - from a treating physician, occupational therapist, psychologist, or other regulated professional - establishing that the accident caused an impairment that prevents the claimant from performing the activity themselves.

In this case, the cognitive and psychological evidence was the deciding factor. The claimant could not safely prepare meals because of accident-related impairments, not because of convenience or preference. The clinical records documented this.

2. Connection between the impairment and the service.

The service must address the specific impairment. If the claimant has a mobility impairment, meal delivery might be justified because they cannot stand long enough to cook. If they have a cognitive impairment, it might be justified because they cannot follow a recipe or safely operate kitchen appliances. The service and the impairment must be causally linked.

3. Reasonableness and necessity.

Even if the service addresses a documented impairment, it must be reasonable and necessary - not just helpful or convenient. Is there a less expensive alternative? Can a family member provide the service? Is the service consistent with the claimant's pre-accident lifestyle?

The insurer will test all three. If any link in the chain is weak, the service will be denied. The decision shows that these denials can be overcome - but only when the clinical evidence is strong.

Meal delivery can also collide with attendant care benefits. If the attendant care plan already covers meal preparation - a personal support worker who cooks for the claimant - a separate meal delivery service for the same need will be challenged as duplication. The insurer's position is simple: the cost is already covered. To avoid the conflict, keep the two claims from overlapping. Either the attendant care plan excludes meal preparation, or the meal delivery request explains why it fills a gap the attendant care does not - for example, meals on days when no attendant is scheduled. Bill one service for the need, not two.

Visitors can also claim meal delivery through a different door: visitor expenses under section 22 of the Schedule. In [SA] v Security National Insurance Company (2026 CanLII 31463), the family of a catastrophically injured child claimed Uber Eats deliveries and Uber rides while visiting him in hospital and rehabilitation. The adjudicator held the meal deliveries were payable to the rehabilitation centre and the family's temporary hotel - where the family stayed to be near the claimant - but not to the family home, where the orders fed the claimant's siblings. Section 22 "provides coverage for visitor expenses and does not extend to meal expenses for the visitor's dependants." The same rule applies: the meal must be anchored to the treatment, not to the visitor's household.

How to Document Non-Traditional Services

If you are a provider recommending or billing for non-traditional services, build the clinical file before you submit the treatment plan.

1. Identify the specific impairment.

Do not say "the claimant has difficulty with meal preparation." Say "the claimant's cognitive impairment, documented in the neuropsychological assessment dated March 2025, affects executive functioning including sequencing, attention, and safety awareness, making meal preparation unsafe without supervision."

2. Explain why the claimant cannot perform the activity.

What specific functional limitation prevents the activity? Can they not stand? Not remember steps? Not safely use appliances? The more specific the explanation, the harder it is for the insurer to dismiss it as a convenience request.

3. Justify why the service is the right solution.

Why meal delivery instead of a PSW preparing meals in the home? Address the alternatives and explain why the proposed service is the reasonable and necessary choice.

4. Attach supporting clinical records.

The OCF-18 is not enough. Attach the relevant sections of the OT assessment, the psychological report, or the physician's clinical notes that document the impairment. Make it easy for the adjuster - and, if necessary, the Tribunal - to see the clinical foundation.

5. Prepare for initial denial.

Non-traditional services are denied more often than standard treatment. This is not a reason to avoid billing them. It is a reason to build a file that can survive reconsideration. The decision shows the reconsideration path works - if the evidence is there.

Other Non-Traditional Services That Follow the Same Rules

The decision's framework applies beyond meal delivery. Any service that falls outside the standard SABS categories - physiotherapy, chiropractic, psychological treatment, and the other explicitly listed services - will be tested the same way:

  • Transportation to medical appointments
  • Home modifications (ramps, grab bars, stair lifts)
  • Mobility aids and assistive devices
  • Ergonomic assessments and workstation modifications
  • Specialized rehabilitation programs

For each one, the three-part test applies: clinical evidence, connection to impairment, reasonableness and necessity. If your file meets all three, bill it. If it does not, build the evidence before you submit.

Conclusion

The reconsideration decision is encouraging for providers who recommend non-traditional services. The Tribunal will approve them when the clinical evidence supports them. But it will not fill gaps in your documentation.

Meal delivery is not automatically payable because a claimant was in a car accident. It is payable because a cognitive or physical impairment from the accident makes meal preparation unsafe or impossible - and because you documented exactly that. The difference between the initial denial and the reconsideration approval was not new facts. It was a Tribunal looking more carefully at the facts that were already there. Make sure your files can survive that second look.