Failure to provide policy or application extends limitation period.

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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A release will not be enforced if it is against public policy.

On April 30, 2014, the BC Court of Appeal ruled in Niedermeyer v. Charlton [2014] B.C.J. No. 763, that a release signed by a plaintiff participating in a zip line activity did not defeat her claim for injuries sustained in a motor vehicle collision on the defendant zip line operator’s bus travelling from the zipline area. The release was contrary to public policy, which did not allow an owner/operator of a motor vehicle to contract out of liability for damages for injuries sustained in a motor vehicle accident.. The plaintiff appealed the decision of the lower court, which at summary...

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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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When a policy lapses, a new agreement must be made.

On January 11, 2013, the  BC Court of Appeal decided in Khosah v. Canada Life Assurance Co. that where coverage under an original policy lapses in accordance with its own terms, the principles of contract formation, rather than contractual interpretation, may apply in determining whether a new policy has come into existence. The issue on appeal was whether the beneficiary’s deceased husband, the insured, obtained temporary insurance coverage from the insurer while the insurer processed the insured’s application for reinstatement of a term life insurance policy that had lapsed due...

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Insurer has 6 years to sue insured.

On November 28, 2012, in Sun Life Assurance Co. of Canada v. Catalano, [2012] B.C.J. No. 2566,British Columbia Supreme Court dismissed an application by an insured under a long term disability policy (“Catalano”) to dismiss an action by the disability insurer (“Sun Life”) seeking to recover insurance monies under a reimbursement agreement. The Court held that the applicable limitation period was six years. Catalano worked for Teck Cominco Metals Ltd. until February 2003. He became disabled and was provided long term disability benefits under a group policy...

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Death benefits denied due to substance abuse.

On April 26, 2012, the New Brunswick Court of Queen’s Bench dismissed an application by a widow for an order that a group creditor insurer pay her pursuant to a policy of insurance following her husband’s death. In Laird v. First Canadian Insurance Corp., the applicant, Mrs. Laird, and her husband, Mr. Laird, purchased group credit insurance when they purchased a new vehicle. On the application for insurance Mr. Laird answered “yes” to a question about whether he suffered from “any illness/disorder of the heart, brain, lungs, kidney, liver, or pancreas (diabetes).” No follow-up medical...

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