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Insurer ordered to pay attendant care benefits and a special award for unreasonably withholding payments.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer, including attendant care benefits, medical benefits for an eye exam, and replacement costs for damaged clothing and prescription sunglasses.
The insurer denied the benefits.
The arbitrator found the applicant was entitled to attendant care benefits at the rate determined by the initial assessment, as the service provider had sustained an economic loss.
The arbitrator also awarded the costs of the eye exam and prescription sunglasses, but denied the clothing claims due to a lack of receipts.
Furthermore, the arbitrator ordered the insurer to pay a special award of 50% of the owing benefits, finding that the insurer had unreasonably withheld payment contrary to the Schedule and ignored evidence of the service provider's economic loss.
An insurer's duty of good faith does not require it to inform an insured of the applicable limitation period when terminating benefits.
The appellant, a self-employed eavestrough installer, purchased disability insurance from the respondent insurer.
After suffering injuries from a fall in 2007, he received disability benefits until November 2011, when the insurer terminated payments.
The insurer's lawyer sent a letter in January 2012 explaining the termination.
The appellant did not commence an action until April 2015, more than two years after the termination.
The motion judge granted summary judgment dismissing the action as statute-barred under the Limitations Act, 2002.
The appellant appealed, arguing that the insurer breached its duty of good faith by failing to inform him of the applicable limitation period when it terminated his benefits.
The Court of Appeal dismissed the appeal, holding that an insurer's duty of good faith does not require it to give notice of a limitation period to its insured.
The court awarded reduced partial indemnity costs to the successful defendant, factoring in reasonableness and the plaintiff's impecuniosity.
The defendant, successful on a summary judgment motion, sought partial indemnity costs of $51,019.50.
The plaintiff argued for no costs due to the novelty of the issue, or a significant reduction due to excessive claims and impecuniosity.
The court found the issue not novel enough to deny costs entirely, affirming the usual rule that costs follow the event.
However, applying principles of reasonableness, proportionality, and access to justice, and inferring the plaintiff's impecuniosity, the court reduced the defendant's claimed fees by excluding pre-litigation work and significantly cutting research/drafting time.
The final costs awarded were fixed at $23,750.00.
Clear denial of disability benefits triggers the limitation period; insurers need not advise of it.
The defendant insurer moved for summary judgment to dismiss the plaintiff's action for disability benefits, arguing it was statute-barred by the Limitations Act, 2002.
The court found the insurer's denial letter was clear and unequivocal, triggering the two-year limitation period in January 2012.
The plaintiff's action, commenced in April 2015, was therefore out of time.
The court rejected the plaintiff's argument that the insurer had a common law duty to advise the insured of the limitation period, stating such an extension of the duty of good faith should be left to the legislature.
The motion for summary judgment was granted, and the action dismissed.
Carriage granted to McSherry class action over competing Mets action in Zimmer hip implant litigation.
Two competing groups of plaintiffs brought carriage and stay motions regarding proposed class actions against Zimmer for allegedly defective hip implants.
The court considered the problematic of multiple class actions across Canada, including the differences between opt-in and opt-out regimes.
The court granted carriage to the McSherry action, which was coordinated with a certified British Columbia class action, and stayed the competing Mets, D'Anna, and Ducharme actions, finding this to be in the best interests of the class members.
Insurer ordered to pay $300 in expenses for failing to attend pre-hearing discussion without notice.
The applicant attended a pre-hearing discussion for a statutory accident benefits dispute, having travelled from Sarnia and taken a day off work.
The insurer's representative failed to attend for personal reasons, but the insurer failed to provide advance notice to the applicant.
The arbitrator found that the applicant incurred needless expenses due to the lack of notice and awarded $300 in expenses to the applicant.
Appeal quashed as the same constitutional issue was previously decided and defendants caused unacceptable delay.
The appellants appealed an order of the motion judge.
The respondent brought a motion to quash the appeal.
The Court of Appeal granted the motion to quash, finding that the same constitutional issue had already been decided in respect of a closely connected defendant in the same proceeding.
The court also noted that the trial was imminent, several plaintiffs were critically ill, and the defendants had engaged in a proliferation of proceedings resulting in unacceptable delay.
Class action certification denied for indirect purchasers in price-fixing conspiracy due to unmanageable pass-on damage issues.
The plaintiffs sought to certify a class action on behalf of indirect purchasers (homeowners and end users) alleging that the defendants engaged in a price-fixing conspiracy regarding iron oxide pigment used in construction materials.
The application judge certified the action.
The defendants appealed.
The Divisional Court allowed the appeal and set aside the certification order, finding that a class proceeding was not the preferable procedure.
The court held that the plaintiffs faced insurmountable problems of proof regarding whether the alleged overcharge was passed on to them through the chain of distribution, making the action unmanageable and inappropriate for aggregate damages assessment.
Action stayed pending appeal of class certification order based on irreparable harm and balance of convenience.
The defendants brought a motion for a stay of the class action proceedings pending their appeal of the certification order.
The court applied the RJR-MacDonald test and found that there was a serious issue to be tried, the defendants would suffer irreparable harm from unrecoverable expenses and reputational damage, and the balance of convenience favoured the defendants.
The action was stayed pending the appeal to the Divisional Court.