A driver's bid for $10,803.86 in hot tub funding fell flat at CAA Insurance - she'd already bought a cheaper one herself.

She was hurt in a 2015 crash when another vehicle ran a red light and struck her car, leaving her catastrophically impaired. Her accident benefits insurer, CAA Insurance Company, had been footing the bill for her ongoing care, but drew the line at a hardshell hot tub - proposed in a treatment plan filed by an occupational therapist in April 2024 and denied a few weeks later.

She said the hot tub genuinely helped. Before the treatment plan was even filed, she'd tried two inflatable models on her own dime and found real relief - less pain, better sleep - before both wore out. "I have consistently found benefit from my use of hot tubs," she testified. Even a medical examiner's report called the price reasonable.

That part was never in dispute, though. What tipped the scales at the Licence Appeal Tribunal was what happened next: once CAA said no, she went out and bought a third hot tub herself - for roughly half the price of the one she wanted covered.

Adjudicator Nadia Mauro said that gap made all the difference. Anyone asking for treatment funding has to show the plan is worth it - reasonable and necessary, in the tribunal's language - and once the claimant already owned a working hot tub bought for about $5,663.95 including tax and accessories, she needed to explain why the pricier model was still worth funding. She didn't. Her sworn evidence never said whether the cheaper spa still worked, or what the costlier one offered that hers didn't.

Mauro also waved off a side dispute over CAA's evidence. The claimant argued the insurer had improperly questioned her credibility - suggesting her earlier hot tubs might not have really broken - without ever cross-examining her on it, a step she said basic fairness rules require. Mauro didn't see it that way, finding CAA's arguments were about whether the hot tub was good enough, not about her honesty. Nothing needed to be tossed out.

Because no benefits were ever overdue, she wasn't entitled to interest either. And CAA didn't have to pay the $300 in costs it faced, after the tribunal found a 52-minute late filing did no real harm to her case.

For claims teams, a claimant's own workaround can end up doing half the insurer's job: once someone shows she can get by for less, a pricier plan needs a much better explanation.