On January 12, 2018 the License Appeal Tribunal released its decision in A.K. and State Farm Insurance Company.
In that case, AK, a minor, was injured in a motor vehicle accident on October 2, 2014 when he was struck as a pedestrian. He applied for accident benefits (no fault benefits) through State Farm, a car insurance company. A series of disputes arose and so the matter proceeded to a hearing before the License Appeal Tribunal. The disputes primarily dealt with the question of whether AK was entitled to access catastrophic benefits which can provide over $1,000,000.00 in benefits.
It was acknowledged by the Applicant that AK had a series of pre-existing conditions that existed before the car accident including a brain injury, epilepsy, and autism spetrum disorder.
After the car accident, AK had a worsening of his conditions according to the argument by AK’s personal injury lawyer, Steven Polak of Lerners LLP. The argument was that AK’s condition had resulted in a severe disability consistent with a score of “3” under the Glasgow Outcome Scale and that he therefore qualified for catastrophic benefits.
State Farm Insurance Company denied that AK met the test and, in part, relied upon reports generated by doctors that they had hired, whose opinions were different than those relied upon by AK.
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The Tribunal ultimately agreed with the Applicant and found that AK did meet the catastrophic impairment definition.