Insured injured 2 days before end of waiting period denied coverage.
On November 20, 2015, the Manitoba Court of Queen’s Bench held that there was no coverage for insured who suffered injury two days prior to expiration of waiting period for coverage under group disability policy. In Funk v. Blue Cross Life Insurance Co., the insured sued his insurer with respect to a group disability insurance policy. The insured had started a new position as a truck driver. One of the benefits offered to him was a group health plan including disability insurance. In order to qualify for coverage one of the provisions of the policy mandated a “Plan Waiting...
read moreManulife guilty of fraudulent concealment.
A judge of the Alberta Court of Queen’s Bench found The Manufacturers Life Insurance Company (“Manulife”) guilty of fraudulent concealment in Atchison v. Manufacturers Life Insurance Company. The trial judgment is found at: Atchison v Manulife, 2002 ABQB 1121. Ms. Atchison’s husband was covered by a group life insurance policy with Manulife. He applied and paid for “excess” life insurance, in addition to his group coverage. The excess policy was issued, with coverage effective one month prior to his death in a boating accident. Manulife paid the...
read moreSelf-represented litigant to pay double costs to insurer.
On September 28, 2015, the BC Supreme Court was required to consider what type of costs award should be granted against a self-represented individual who was unsuccessful at trial. In Wright v. Sun Life Assurance Co. of Canada, 2015 BCSC 1899, the insurer made an offer to settle the case prior to trial. The plaintiff did not accept. Ultimately, the claim was dismissed and the plaintiff received no award. The Court held that the insurer’s offer to settle ought reasonably to have been accepted, as the plaintiff’s view of his entitlement and likelihood of recovery was unrealistic. The Court...
read moreDelay not always a bar to a disability claim.
On September 21, 2015, the Ontario Court of Appeal upheld a lower court’s decision to grant relief from forfeiture in Dube v. RBC Life Insurance Company, 2015 ONCA 641. Gregory Dube worked for a Community Housing Corporation in Windsor, Ontario. As a full-time employee, Dube was insured by RBC Life Insurance Co. against the risk of suffering a long-term disability. The RBC policy required claimants to submit proof of their claim to RBC within 90 days from the start of their disability, but granted an extra year to submit proof of the claim if they could not do so within 90 days. On May...
read moreInsurer has no duty to investigate, says Court.
On June 30, 2015, the Nova Scotia Supreme Court held that an insurer has no duty to investigate the information provided by the insured to unearth misrepresentations by the insured. A broker was held liable for failing to make inquiries into whether an insured’s representative who completed the insurance applications had the necessary training or experience to do so and if not to discuss the benefits of property inspections with him. The insured was apportioned 50% liability for failing to ensure that its representatives handling the placement of insurance had sufficient knowledge...
read moreInsuring both tortfeasor and victim creates conflict.
On April 24, 2015, a 3-judge panel of the Ontario Superior Court of Justice – Divisional Court, held that where an insurer insures both the tortfeasor for liability coverage and the victim for accident benefits, the insurer should set up a firewall so that information gathered by it regarding the accident benefits claim is not available in the tort action. In Dervisholli v. Cervenak the plaintiff insured was involved in a motor vehicle collision. The insurer insured both the plaintiff’s vehicle and the defendant’s vehicle under separate automobile policies. The plaintiff brought...
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