Dismissal of Insureds Claim for Disability Benefits was Upheld on Appeal

Decision granting summary judgment dismissing insured’s action was upheld on basis that insured did not meet qualifying conditions of disability policy and commenced action more than two years after becoming aware of disability.

Insurance law – Disability insurance – Long term disability benefits – Proof of disability – Policies and insurance contracts – Limitation of actions – Running of limitation period

Thompson v. Sun Life Assurance Co. of Canada, [2015] O.J. No. 1195, March 12, 2015, Ontario Court of Appeal, E.A. Cronk, E.E. Gillese and D. M. Brown JJ.A.

The appellant insured appealed from the granting of summary judgment dismissing her action against a long term disability insurer.

The insured was employed by Casino Rama Services Inc. (“Casino Rama”) from June 1996 until September 19, 2008. The insured commenced her action on September 17, 2010 claiming payment of long term disability benefits from September 20, 2008 for the duration of her disability. The insured had not submitted any proof of claim under the policy seeking disability benefits.

The primary ground of appeal advanced by the insured was that the motion judge had erred in concluding that her action was barred by a contractual one year limitation provision contained in the policy. The Court of Appeal agreed that the motion judge erred in reaching this conclusion; however, found that he made other findings which supported the dismissal of the action. In particular, the court found that the insured had not met the qualifying conditions of the policy and that the insured’s action was barred by the statutory two year limitation period because in the statement of claim she alleged that she discovered her total disability in August 2008; however, she did not commence the action until more than two years later on September 17, 2010. In the result, the appeal was dismissed.

This case was digested by Cameron B. Elder and edited by David W. Pilley of Harper Grey LLP. If you would like to discuss this case further, please feel free to contact them directly at [email protected] or [email protected] or review their biographies at http://www.harpergrey.com.

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