The plaintiff, who was disabled from working at medium and heavy employment was nevertheless not totally disabled from an occupation within the range of his education, training and experience

31. October 2005 0

Plouffe v. Mutual Life Assurance Co. of Canada, [2005] B.C.J. No. 2382, British Columbia Supreme Court

Mr. Plouffe was injured in an automobile accident in August of 1996. He suffered soft tissue injuries to his neck and back. He was authorized by his physician to stay off work and attend a work hardening program. He recovered partially from his soft tissue injuries but was disabled from engaging in heavy, repetitive work. Although at the time of the accident Mr. Plouffe was working as a mechanic for a trucking firm, prior to that he had had extensive experience in retail sales. Mr. Plouffe had a policy of disability insurance with Mutual Life Assurance Company of Canada (“Mutual Life”). Mr. Plouffe was entitled to disability benefits under his policy of insurance if he suffered an injury such that he was unable to engage in any occupation for which he was suited by education, training and experience. Manulife determined that although Mr. Plouffe was disabled from returning to his employment as a mechanic, he was not disabled from engaging in retail sales and declined to pay policy benefits to him.

Mr. Plouffe commenced an action against Manulife for a declaration of entitlement to disability benefits. At trial, Mr. Plouffe did not adduce evidence from any physician that his condition limits his capacity to function to such extent that he cannot engage in retail sales. Rogers J. determined that retail sales was an occupation which Mr. Plouffe was suited to by education, training and experience. Rogers J. noted that he accepted that Mr. Plouffe generally believed that he could not work in any occupation, but relied upon Mathers v. Sun Life Assurance Company of Canada (1999), 9 C.C.L.I. (3d) 151 for the proposition that this was not a sufficient basis upon which one could declare an entitlement to benefits under a policy of disability insurance. Mr. Plouffe’s claim for a declaration of entitlement to benefits was dismissed.

In addition, Rogers J. noted that since Mr. Plouffe had no entitlement to disability benefits, he could not prosecute a claim for punitive or exemplary damages against Mutual Life, and the bad faith aspect of the claim was dismissed as well.

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