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 moving party, Facca Incorporated, brought a motion for leave to appeal a November 2019 order.

The Divisional Court dismissed the motion for leave to appeal.

Costs of $2,000 were awarded to the third party, The Manufacturers Life Insurance Company, payable by the moving party.

No costs were awarded to the responding plaintiff as no costs submissions were received.

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 respondent's husband applied for life insurance without disclosing his criminal past, membership in a terrorist entity, and illegal entry into Canada.

After his death, the respondent claimed the $75,000 death benefit.

The motion judge granted summary judgment for the respondent, finding the undisclosed facts were not material because the application did not ask about them.

The Court of Appeal allowed the insurer's appeal, holding that the deceased had an independent obligation to disclose material facts and that his intentional withholding of this information constituted fraud, vitiating the policy.

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 applicant alleged that the respondent discriminated against him on the basis of disability by providing inferior customer service and making calculation errors regarding his disability benefits, compared to the service provided for his other financial products.

The Tribunal held a summary hearing and dismissed the applications, finding no reasonable prospect of success.

The Tribunal concluded that the different financial products were not comparable services and that there was no evidence linking the alleged poor service to the applicant's disability.

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 appellant appealed a decision allowing her long-term disability (LTD) insurer to deduct the amount of a Non-Earner Benefit (NEB) she received from her auto insurer following a second accident.

The appellant argued that based on the 'apples to apples' principle, the NEB (a non-income benefit) should not be deducted from LTD payments (an income benefit).

The Court of Appeal dismissed the appeal, holding that the 'apples to apples' principle applies to statutorily-mandated deductions from tort awards, whereas this deduction was governed by the clear and unambiguous language of the LTD insurance policy, which permitted the deduction of 'any disability benefit'.

The plaintiff was injured in a motor vehicle accident and sued her long-term disability insurer after being denied benefits.

She was receiving income replacement benefits from her accident benefits insurer.

The accident benefits insurer successfully moved to be added as a defendant to help the plaintiff secure long-term disability benefits, which would reduce its own payment obligations.

The long-term disability insurer appealed.

The Divisional Court allowed the appeal, finding that the accident benefits insurer was not a necessary party under Rule 5.03 and had no direct cause of action against the long-term disability insurer.

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.

In a personal injury action involving statutory accident benefits and long-term disability benefits, the automobile insurer cross‑claimed against the long‑term disability insurer for reimbursement of income replacement benefits paid to the insured.

The cross‑claim alleged unjust enrichment, asserting that the LTD insurer should have paid benefits first.

The court held that under s. 7 of the Statutory Accident Benefits Schedule an automobile insurer may deduct LTD payments only if they are actually received or the insured failed to apply for them.

Because the insured applied for LTD benefits and the LTD insurer denied the claim, the automobile insurer could not deduct hypothetical benefits or recover them through unjust enrichment.

The court found no enrichment, no corresponding deprivation, and no unjust retention, and struck the cross‑claim.