Pre-existing condition exclusion in group disability insurance upheld as reasonable and bona fide under Human Rights Code.
The complainant, who was diagnosed as HIV-positive shortly after commencing employment, was denied long-term disability benefits due to a pre-existing condition exclusion clause in the employer's group insurance policy.
The clause excluded coverage for disabilities arising from conditions for which the employee received medical care during the 90-day probationary period.
The Board of Inquiry found that while the clause was prima facie discriminatory, it was saved by section 25(3)(a) of the Human Rights Code as a reasonable and bona fide distinction based on a pre-existing handicap that substantially increases risk.
The Board applied the Supreme Court's test from Zurich Insurance, concluding the clause was a sound and accepted insurance practice for small groups to prevent adverse selection, and that no practical alternative existed.
Ontario (Human Rights Comm.) v. North American Life Assurance Co. (No. 5), 1992 CanLII 14239
