D. Brown

The appellant was receiving long-term disability benefits from the respondent insurer.

The parties had previously settled a dispute regarding the calculation of benefits, executing Minutes of Settlement and a Release that affirmed the policy continued to apply.

The appellant later received retroactive Canada Pension Plan (CPP) disability benefits, and the insurer sought to deduct these from her long-term disability benefits as a direct offset under the policy.

The appellant applied for a declaration that the Minutes of Settlement precluded this deduction.

The application judge dismissed the application, finding the settlement did not modify the policy's CPP offset provision.

The Court of Appeal upheld the decision, confirming that the contractual interpretation was correct and the policy's offset provisions remained in effect.

The appellant law firm appealed a decision regarding the interpretation of s. 39(6) of the General Regulation under the Health Insurance Act, which dictates how the Ontario Health Insurance Plan shares the legal costs of an insured person who recovers damages including a subrogated claim for the Plan.

The Court of Appeal held that 'the total recovery of the insured person' includes the amount recovered on behalf of the Plan.

Furthermore, the Court clarified that when an insured person recovers costs, those costs must first be deducted from the total legal costs payable to their lawyer before calculating the Plan's proportionate share of the net costs.