Scott Douglas McTaggart

The plaintiff, Istvan Hirosik, brought a summary judgment motion seeking long-term disability benefits from Canada Life Assurance Company, along with aggravated, exemplary, and punitive damages.

The central issue was whether Hirosik's current lumbar spine disability qualified as a new claim or a recurrent disability under the policy, given his complex medical history.

The defendant argued the motion was inappropriate due to insufficient medical evidence to assess disability, causation, and credibility.

The court dismissed the motion, finding the medical issues too complex for summary judgment without a complete medical record and expert evidence, and directed the matter to proceed to trial.

The applicant sought a declaration that he was entitled to a $1,000,000 critical illness benefit under a policy after being diagnosed with papillary thyroid cancer.

The insurer denied coverage relying on a policy exception excluding benefits where, within 90 days of the policy’s effective date, the insured experienced signs, symptoms, or investigations that led to a cancer diagnosis regardless of when the diagnosis was made.

The court interpreted the exclusion clause according to established principles of insurance contract interpretation and held the language was clear and unambiguous.

The discovery of thyroid nodules during a carotid Doppler test within the 90‑day window constituted a sign that ultimately led to the cancer diagnosis months later.

The insurer therefore properly relied on the exclusion clause to deny the claim.