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Appeal allowed and summary judgment granted as the claim for income replacement benefits was statute-barred.
The appellant insurer appealed the dismissal of its motion for summary judgment.
The insurer argued that the respondent's claim for income replacement benefits was barred by the two-year limitation period under s. 281.1 of the Insurance Act.
The motion judge had found a genuine issue for trial based on an error in a subsequent denial form and a fresh medical finding.
The Divisional Court allowed the appeal, holding that the initial clear and unequivocal denial triggered the limitation period, and a fresh medical finding could not reactivate it.
Summary judgment was granted dismissing the claim.
Leave to appeal granted on limitation period for statutory accident benefits claim.
The defendant insurer brought a motion for leave to appeal a decision refusing summary judgment in an action for statutory accident benefits.
The underlying action had been commenced more than four years after the insurer’s initial denial of benefits, despite a statutory two‑year limitation period under the Insurance Act and the Statutory Accident Benefits Schedule.
The motion judge declined summary judgment due to concerns about a subsequent denial form containing an error and a later medical report suggesting fibromyalgia related to the accident.
The court held that the law is well settled that the two‑year limitation runs from the insurer’s refusal and is not subject to discoverability.
Leave to appeal was granted because the decision appeared inconsistent with other Ontario authorities and clarification of the limitation rule was important.
Administrative dismissal set aside where delay explained and no prejudice shown.
The plaintiff brought a motion under Rule 37.14 of the Rules of Civil Procedure to set aside an administrative order dismissing the action as abandoned pursuant to Rule 48.15(1).
The court applied the four‑factor test from Reid v. Dow Corning Corp., considering explanation for delay, intention to proceed, promptness of the motion, and prejudice to the defendant.
The court found the delay was largely attributable to procedural missteps and indulgences between counsel, and that the plaintiff had always intended to proceed with the action.
The defendant failed to demonstrate actual prejudice arising from the delay.
The administrative dismissal order was therefore set aside and no costs were awarded.
Arbitration dismissed; applicant failed to establish a reasonable excuse for 20-month delay in claiming benefits.
The applicant was injured in a motor vehicle accident in January 1993 but did not notify the insurer or apply for statutory accident benefits until September 1994, almost 20 months later.
The insurer denied the claim due to the delay.
On a preliminary issue hearing, the arbitrator found that the applicant, who was a licensed insurance broker, did not have a reasonable excuse for the delay.
The applicant's assertion that she did not know the full extent of her injuries was rejected, as she had sought medical treatment shortly after the accident and was referred to a specialist within 13 months.
The arbitration was dismissed.
