Gordon Jermane

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.

The appellants sought long-term disability benefits for a disability allegedly arising in 1990, despite their insurance policy having been cancelled that same year for non-payment of premiums.

The action was commenced in 2005.

The motion judge granted summary judgment to the respondent, finding the limitation period had expired and the individual appellant was not saved by the incapacity provision in s. 7 of the Limitations Act, 2002.

The Court of Appeal dismissed the appeal, agreeing there was no medical evidence demonstrating the appellant lacked the capacity to commence the action.

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.

The appellants appealed a judgment dismissing their claim against the respondent insurer.

The Court of Appeal upheld the motion judge's finding that the limitation period expired in 2005.

The court rejected the appellants' argument that equitable doctrines, such as unjust enrichment, could override the express terms of the insurance contract, the Limitations Act, 2002, and the Insurance Act, particularly since the claim did not fall within the policy terms as it was not an accident.

The appeal was dismissed with costs.

The defendant insurer sought leave to appeal a motion judge's refusal to strike the plaintiff's jury notice in an action for life insurance proceeds.

The insurer argued the claim was for declaratory relief, which must be tried without a jury under s. 108(2) of the Courts of Justice Act.

The court dismissed the motion for leave to appeal, finding no good reason to doubt the motion judge's conclusion that the pith and substance of the claim was a factual dispute regarding the deceased's insurability, rather than a claim for declaratory relief.

The appellant appealed the trial judge's decision, which was based on the credibility of witnesses, surveillance video, and the appellant's failure to disclose relevant information to his doctors and on his CPP application.

The Court of Appeal found no palpable and overriding error in the trial judge's decision and dismissed the appeal with costs fixed at $4,500.