Bustamante v. The Guarantee Company of North America, 2015 ONCA 530 (CanLII)

Released July 13, 2015 | CanLII

This is an appeal by the Plaintiff from the judgment of Ramsay J., granting summary judgment and dismissing the Plaintiff’s claim for non-earner benefits (“NEBs”) as time-barred. At the time of the accident on June 3, 2004, the Plaintiff was a hairdresser. She elected income replacement benefits (“IRBs”), although her disability certificate indicated that she was entitled to both IRBs and NEBs. On September 1, 2004, the Defendant accepted her entitlement to IRBs and indicated that she would not be eligible for NEBs by way of an OCF-9. She was also informed of her right to dispute the refusal and the limitation period. The Defendant then found that the Plaintiff was not entitled to IRBs more than 104 weeks after the accident and terminated her IRBs on July 26, 2006. She returned to work in September 2006. On September 25, 2009, the Plaintiff applied for NEBs, which were ultimately denied by letter dated January 19, 2010.

The Court of Appeal affirmed Ramsay J.’s conclusion that the Plaintiff’s claim for NEBs was time-barred. The Court noted that the Defendant terminated the Plaintiff’s IRBs on July 26, 2006 and that the Plaintiff did not re-assert a claim for NEBs within two years of that termination. The Court rejected the Plaintiff’s argument that the Defendant could not rely on its September 1, 2004 denial of the NEBs as she was not eligible for the NEBs at that time; this line of reasoning would mean that the limitation period for making a claim for NEBs was never triggered. The Court further held that the September 1, 2004 denial was a clear refusal to pay NEBs which triggered the limitation period and dismissed the appeal.

Read the full decision on CanLII

Nga Dang
Written by

Nga has practiced exclusively in personal injury since her call to the bar. Nga is very compassionate towards those who have suffered a loss and aims to guide clients through difficult legal processes. She is also dedicated to promoting access to justice for injured members of the Vietnamese community. With her fluent Vietnamese language skills, she hopes to lower the communication barriers faced by many injured members of her community and help them obtain appropriate compensation.