Limitation period extended by insurer’s failure to provide policy or application.

On  November 4, 2014, the Ontario Superior Court of Justice found that an application for long-term disability benefits under a policy issued to his employer, submitted two and a half years after the deadline, was not submitted out of time because the insured had not been provided with the policy or claims documents by his employer. In Nguyen v. SSQ Life Insurance Co., 2914 ONSC 6405, the insurance company made an application to dismiss Mr. Nguyen’s claim for long-term disability benefits under a group policy issued to his employer, on the basis that the claim was made out of time. Mr....

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One judge’s clarity is another’s ambiguity.

On June 4, 2013, the BC Court of Appeal reversed a trial decision in McLean v. Canadian Premier Life Insurance, 2013 BCCA 264,and in an unanimous decision allowed the appeal and held that the insured was entitled to the $1 million benefit provided by the policy. The McLean appeal decision is an interesting example of how one judge’s clarity is another’s ambiguity. The trial judge found that “the words of the contract are clear and unambiguous” and held that the loss did not come within the policy terms. Specifically, holding that at the time of the loss the deceased insured was not a...

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LTD claim reviewing MAY extend a limitation period.

An application by a long term disability insurer to dismiss a claim commenced by an insured on the basis that the claim was barred by the expiration of the limitation period. The application was dismissed and costs awarded to the plaintiff. In White v. Manufacturers Life Insurance Co. (c.o.b. Manulife), [2011] B.C.J. No. 2273, the plaintiff was insured for a long term disability benefits under a group policy issued by the defendant, Manulife Insurance. The plaintiff submitted an application for disability benefits on September 13, 2006. On July 12, 2007 Manulife advised the plaintiff that...

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Manulife loses “want of prosecution” application.

On May 30, 2011, the BC Supreme Court decided that Manufacturers Life Insurance Company (“Manulife”), successor to the Aetna Life Insurance Co. of Canada (“Aetna”) was unsuccessful in its application for an order dismissing an applicant’s action for want of prosecution. The decision is reported at: Toor v Aetna Life Ins. Co., 2011 BCSC 691. In 1975 the applicant, Harbans Toor purchased a policy of long-term disability insurance from Excelsior Life and the policy was eventually acquired by Manulife. In the action, Mr. Toor claimed, among other things, for benefits under that...

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Manulife tried to avoid its own policy, and failed.

On August 17, 2009, The BC Supreme Court held that as between the limitation period in an insurance policy and the limitation period set out in Section 22(1) of the Insurance Act of British Columbia, the limitation period in the policy prevails so long as it is not shorter than that prescribed by Section 22(1). In Colgur v. Manufacturers Life Ins. Co., 2009 BCSC 1125, the insurance company, Manulife, applied for a dismissal of the Ms. Colgur’s claim for long-term disability .  Ms. Colgur was employed by the Royal Bank of Canada as a customer service representative. She developed laryngitis...

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An exclusion clause is only valid if it is unambiguous.

On September 16, 2008 the Alberta Court of Appeal confirmed in Duke v. Clarica Life Insurance Co. 2008 ABCA 301 that an ambiguous term in a critical illness policy exclusion clause should be construed against the insurer. The insurance company had issued a critical illness policy to Mr. Duke. When Mr. Duke developed Parkinson’s disease, the insurance company denied his claim, relying on an exclusion clause which stated: “if the insured person had a covered critical illness or any symptoms associated with a covered critical illness before the date the Policy came into...

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