Sophia Chaudri

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.

The court determined the appropriate interest payable on unpaid Income Replacement Benefits (IRBs) following a jury verdict in favor of the plaintiff.

The plaintiff sought interest under s. 46(2) of the Statutory Accident Benefits Schedule (SABS) (2% compounded monthly), while the defendant argued for pre-judgment interest under the Courts of Justice Act (CJA) (4.5% simple annual).

The court found that the claim for SABS interest was implicitly pleaded or, in the alternative, an amendment to the Statement of Claim would be permitted.

The court further ruled that SABS interest would apply from March 30, 2006, recognizing an initial period (February 20, 2004, to March 15, 2006) where the plaintiff's own conduct (misleading disability certificate) justified the insurer's non-payment, during which CJA interest would apply.