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. Nguyen began work for his employer in 2009. He could not read or write English and had limited ability understanding spoken English. Mr. Nguyen may not have been provided with a copy of the group insurance policy or any benefit booklet setting out the group insurance policy’s terms and conditions.

Mr. Nguyen was injured in a motor vehicle accident in March 2010. He told his employer that he was injured and unable to return to work. The employer neither advised him to make a claim for long-term disability benefits nor provided him with any documents which would allow him to do so.

Under the terms of the policy, Mr. Nguyen’s claim for long-term disability benefits was to be submitted no later than September 2010. Mr. Nguyen only became aware of the long-term disability benefits available to him in January 2013, after he was asked about them in an examination for discovery. In April 2013, Mr. Nguyen applied for long-term disability benefits which the insurance company denied.

The court dismissed the insurance company’s application, and made a binding determination that Mr. Nguyen’s application was timely because Mr. Nguyen showed that he was unable to submit an application earlier. Mr. Nguyen could not submit a claim earlier because his employer did not provide him, as it was obligated to do, with the documents required to exercise his rights under the group insurance policy. The court went on to say that, even if the application was not timely, Mr. Nguyen would have been entitled to relief from forfeiture.