This appeal concerned the interpretation of s. 37(4) of the Statutory Accident Benefits Schedule (SABS) regarding an insurer's obligation to provide reasons for terminating income replacement benefits (IRBs).
The Licence Appeal Tribunal (LAT) found the applicant's claim time-barred, as Allstate's termination letter, which cited the applicant's return to full-time work, was deemed sufficient.
The Divisional Court overturned this, holding that s. 37(4) required medical reasons in all termination letters, interpreting "medical and any other reasons" conjunctively.
The Court of Appeal allowed the insurer's appeal, finding the Divisional Court erred in its interpretation.
The Court of Appeal held that "and" in s. 37(4) can be interpreted in a joint or several sense, meaning medical reasons are not required if the termination is based solely on a non-medical ground, such as return to work.
The insurer's letter was found to comply with the SABS, and the limitation period was validly triggered.
