Donna M. Kraft

The respondent was injured in a motor vehicle accident and submitted a claim for long-term disability benefits well beyond the policy's time limits.

The appellant insurer denied the claim and moved for summary judgment.

The motion judge granted the respondent relief from forfeiture under s. 98 of the Courts of Justice Act, finding minimal prejudice to the insurer.

The Court of Appeal dismissed the insurer's appeal, holding that the motion judge reasonably applied the three-part test for relief from forfeiture given the abundance of medical information available and the insurer's failure to request independent assessments.

The insurer moved for summary judgment dismissing a long-term disability claim on the basis that notice and proof of claim were delivered outside the contractual deadlines in a group policy.

The insured asserted relief from forfeiture, relying on confusion about coverage, misleading information from the employer, and the absence of actual prejudice given the extensive medical record.

The court held that timely notice was a matter of imperfect compliance for which equitable relief could be available, and applied the three-part s. 98 Courts of Justice Act framework.

It found the insured's conduct reasonable, the breach relatively modest, and the disparity between the forfeited benefits and the damage caused by the breach significant.

Summary judgment was dismissed and a binding determination granting relief from forfeiture was made.

The appellant appealed a summary judgment decision denying her claim against her group disability insurer for benefits.

She argued the insurer had a common law duty to inform her directly of a potential claim, and that the limitation period should not run until they did so.

The Court of Appeal dismissed the appeal, finding no such common law duty exists for group disability insurers in these circumstances, and noting the insurer had complied with the statutory notification obligations under the Insurance Act.

The respondent insured received long-term disability benefits from the applicant insurer while appealing a denial of WSIB benefits.

The policy allowed the insurer to deduct 100% of WSIB benefits from the disability payments and required the insured to reimburse any overpayment.

When the WSIB appeal succeeded, the insured's counsel withheld a portion of the retroactive WSIB payment for legal fees.

The insurer brought an application to recover the gross WSIB amount.

The court granted the application, finding the policy language unambiguous and rejecting arguments based on unjust enrichment and the 'made whole' doctrine.

The appellant appealed an order of the Superior Court of Justice.

The Court of Appeal dismissed the appeal, finding no error in the motion judge's reasons and noting that his conclusions were amply supported by the evidence, particularly the expert reports.

Costs of $10,000 were awarded to the respondents.

The appellants appealed a trial judgment finding they failed to establish that the respondent life insurance company waived the dependency requirement in the insurance policy.

The Court of Appeal agreed with the trial judge and dismissed the appeal, awarding costs of $10,000 to the respondent.

The insured died of carbon monoxide poisoning while repairing his son's motor vehicle in a closed garage with the engine running.

His blood alcohol level exceeded 80mg/100ml.

The appellant insurer denied coverage under an accidental death policy, relying on an exclusion clause for losses caused by 'operating a motor vehicle' while intoxicated.

The trial judge found the insured was not 'operating' the vehicle.

The Court of Appeal upheld the decision, finding that exclusion clauses must be interpreted narrowly and that 'operating' a vehicle, especially in the context of a blood alcohol threshold, focuses on driving rather than repairing.