Gordon Jermane

The plaintiff sought long-term disability (LTD) benefits and general damages for breach of contract, claiming total disability due to chronic back and leg pain, anxiety, and depression.

The plaintiff had not submitted a formal LTD application, seeking relief from forfeiture.

The court granted relief from forfeiture, finding imperfect compliance.

However, the court ultimately dismissed the plaintiff's claim for LTD benefits and general damages, finding that he failed to prove total disability as defined by the policy, largely due to inconsistencies between his subjective complaints, objective medical evidence, video surveillance, and his work history.

The plaintiff brought a motion to enforce a settlement agreement reached with the defendants regarding employment and insurance coverage actions.

The parties agreed on the settlement terms, including a $300,000 payment, but disagreed on the wording of the release.

The defendants sought a broad release that could potentially bar an ongoing oppression action, while the plaintiff sought to explicitly carve out the oppression action.

The court rejected both proposed releases, holding that the release must reflect the settlement agreement, and ordered a simple release limited to the claims made in the settled actions.

The insured renewed a travel insurance policy by telephone, providing answers about medical conditions.

After hospitalization, the insurer denied the claim due to alleged misrepresentation.

The insured's estate argued that the insurer could not rely on oral statements, asserting that Statutory Condition 2 of the Insurance Act required written statements.

The court dismissed the application, holding that the insurer's practice of providing a written application for review and correction after the telephone interview satisfied the statutory requirement and the consumer protection objectives of the Insurance Act.

The plaintiff sought critical illness insurance benefits after being diagnosed with cancer, two months after he had requested cancellation of his policy.

Both parties moved for summary judgment.

The court found that the policy unambiguously required a diagnosis to occur while coverage was in force.

Since the diagnosis occurred after the policy was cancelled due to the plaintiff's own initiative and non-payment of premiums, there was no coverage.

The court also denied relief from forfeiture, as the policy had terminated due to non-payment, not a breach, and thus no property was forfeited.

The plaintiff's motion was dismissed, and the defendant's motion for summary judgment was granted.

The plaintiff was terminated and entered into a settlement agreement with his employer, which required him to seek reasonable alternate employment to receive two $75,000 payments.

Shortly after, the plaintiff became severely disabled and could not seek employment.

The employer refused to pay, arguing failure to mitigate or frustration of contract.

The court granted summary judgment to the plaintiff, finding his disability excused the condition.

The plaintiff and employer also sought summary judgment against the employer's group insurer for long-term disability coverage, arguing the policy's 'minimum period required by law' included common law notice.

The court dismissed the motions against the insurer, finding a genuine issue for trial regarding the interpretation of the clause and industry practice.

An employee of nine years with Standard Life Insurance (acquired by Manulife) submitted a resignation letter effective December 31, 2016, prompted by the company's announcement of a new computer system conversion.

The employee's supervisor told her she could rescind the notice if she changed her mind.

When Manulife cancelled the computer conversion three weeks later, the employee withdrew her resignation notice.

The employer refused to recognize the withdrawal and terminated the employee on December 12, 2016.

The motion judge found the resignation was clear and unequivocal and dismissed the wrongful dismissal claim.

The Court of Appeal reversed, finding the resignation was equivocal given the circumstances and the employee was entitled to withdraw it.

The court awarded 12 months' salary in lieu of notice.

The plaintiff, Fadia Mohammad, sought summary judgment for payment of a life insurance death benefit following the death of her husband, Mahmoud Mohammad.

The defendant insurer, Manulife, denied the claim, alleging fraudulent misrepresentation by the deceased regarding his immigration status (by providing a Social Insurance Number, SIN) and his criminal past (non-disclosure) on the application form.

The court found that providing a SIN did not constitute a misrepresentation of immigration status.

Furthermore, the court held that there was no duty to disclose immigration status or criminal history because the insurer's application form did not ask questions to elicit this information, implying these facts were not material.

Even if material, the non-disclosure was not fraudulent.

The court emphasized that an insurer's failure to inquire about specific facts may indicate those facts are not material, and relying on non-disclosure in such circumstances can be contrary to the insurer's good faith duty.

The plaintiff's motion for summary judgment was granted, and the defendant's motion was dismissed.

The plaintiff sought summary judgment for wrongful dismissal, arguing she could rescind her notice of retirement.

She had submitted a written notice of retirement effective December 31, 2016, but later orally sought to withdraw it after a company conversion project was suspended.

The defendant maintained the retirement was binding.

The court examined whether an employee can rescind a resignation after it has been accepted by the employer, concluding that once a clear and unequivocal resignation is accepted, it forms a binding contract that cannot be unilaterally resiled from.

The plaintiff's claim was dismissed.

Appellant suffered a traumatic brain injury and severe back injury during a company-sponsored event while employed by respondent.

Appellant was unaware of the permanent and disabling nature of the brain injury until after resignation.

Appellant subsequently applied for long-term disability benefits under the employer's policy approximately five years after the injury occurred.

The insurer denied the claim on the basis that coverage terminated upon cessation of active employment.

The trial court upheld the denial.

On appeal, the court reversed, holding that the policy language, when read as a whole, provides coverage for claims arising from incidents occurring during the currency of employment, regardless of when the claim is subsequently filed.

The court also granted relief from forfeiture for the late filing of proof of claim and addressed the applicability of contractual and statutory limitation periods.

The plaintiff sued his disability insurer for long-term disability benefits.

The insurer brought a motion for summary judgment to dismiss the action, arguing that a $314,843 settlement the plaintiff received from his former employer upon termination was fully deductible from his LTD benefits under the policy.

The court dismissed the motion, finding that the nature and component parts of the settlement package were unclear from the documentary record.

The court concluded there was a genuine issue requiring a trial to determine whether the settlement funds constituted income replacement or disability payments subject to deduction.

The plaintiff, Mr. MacIvor, sought long-term disability (LTD) benefits from Manulife under a group insurance policy held by his former employer, Pitney Bowes, after being seriously injured.

Manulife denied liability, arguing that the plaintiff's coverage ceased when he resigned from Pitney Bowes and that his claim was made after the limitation period.

The court found that the plaintiff was not a "Covered Person" under the policy at the time he made his claim, as coverage terminated upon his resignation.

Section 297(1) of the Insurance Act was deemed inapplicable as the policy itself had not terminated.

Consequently, the plaintiff's action was dismissed.

An employee who became disabled from employment as a police constable applied for long-term disability benefits under a group insurance policy issued by the respondent insurer.

When the insurer terminated the benefits, the employee sued the insurer for payment.

The motion judge struck the claim on the basis that the collective agreement governing the employee's employment granted exclusive jurisdiction over the matter to labour arbitration.

The Court of Appeal upheld the dismissal, finding that the collective agreement did more than merely oblige the employer to pay insurance premiums; it covered the terms, amount, and definition of disability benefits and made specific reference to the insurance policy.

Therefore, the employee's entitlement to benefits arose from the collective agreement, making the dispute arbitrable.

The defendant insurer sought leave to appeal an interlocutory order dismissing its Rule 21 motion to strike the plaintiff’s statement of claim for failure to disclose a reasonable cause of action.

The underlying action arose from allegations that the insurer improperly required the plaintiff to pursue Canada Pension disability benefits and forced him into a collateral agreement, resulting in legal costs and damages.

The court held that the defendant failed to demonstrate conflicting authority or provide good reason to doubt the correctness of the motion judge’s decision.

Accepting the pleadings as true, the claim raised issues relating to contractual obligations, potential unjust enrichment, and alleged bad faith.

Leave to appeal was therefore refused.

The defendant, Manulife, brought a motion to strike the plaintiff's statement of claim under Rule 21.01(1)(b), arguing it disclosed no reasonable cause of action.

The plaintiff, who was receiving long-term disability benefits, successfully appealed a denial of CPP disability benefits using a lawyer, and sought to deduct his legal fees from the retroactive CPP amount owed to Manulife as an overpayment.

The plaintiff pleaded breach of contract, unjust enrichment, and bad faith.

The court dismissed the motion, finding it was not plain and obvious that the plaintiff's claims, including differing interpretations of the contract and unjust enrichment, would fail.

The applicant, a member of the Canadian Armed Forces, sought a declaration of entitlement to benefits under an accidental dismemberment insurance policy after losing his leg following complications during knee surgery related to a service injury.

The insurer denied coverage, arguing the loss did not arise from military service and was excluded as resulting from medical or surgical treatment.

The court held the surgery arose out of the applicant’s military service because it was undertaken to address limitations affecting his military career.

The transection of the artery during surgery constituted an accidental injury, and the insurer failed to establish that the exclusion for medical or surgical treatment applied.

The applicant was therefore entitled to the $125,000 dismemberment benefit plus prejudgment interest.

Following dismissal of a claim for payment of an accidental death benefit under a group insurance policy, the successful defendant sought partial indemnity costs exceeding $28,500.

The central issue at trial had been whether the deceased insured’s blood alcohol concentration exceeded the policy exclusion threshold of .08, which the court ultimately found it did based on toxicology evidence.

In determining costs under s.131 of the Courts of Justice Act and Rule 57.01 of the Rules of Civil Procedure, the court considered the plaintiff’s reasonable basis for pursuing the claim, limitations in the toxicology evidence before trial, and the plaintiff’s financial circumstances.

Emphasizing fairness, proportionality, and access to justice, the court significantly reduced the costs award despite the defendant’s success and an offer to settle.

The defendant was awarded modest all-inclusive costs.

The plaintiff sought payment of a $100,000 accidental death benefit under a group life insurance policy after the insured died in a motor vehicle accident.

The insurer paid the basic life benefit but relied on an exclusion denying coverage where an accident occurs while the insured operates a vehicle with a blood alcohol concentration exceeding 80 mg/100 ml.

Expert evidence was called regarding the reliability of post‑mortem toxicology testing and the insured’s blood alcohol level at the time of death.

The court accepted the reliability of the femoral blood sample analysis showing a concentration of 211 mg/100 ml and held the insurer met its burden of proving the exclusion on a balance of probabilities.

The court further held the exclusion did not require proof that alcohol caused the accident, only that the accident occurred while the insured’s BAC exceeded the specified level.