Bonaccorso v. Optimum, 2016 ONCA 34

Released January 14, 2016 | Full Decision

The plaintiff was involved in a motor vehicle collision on February 4, 2008. She received income replacement benefits from her insurer Optimum. On June 28, 2009 (within the initial 104 week period), the plaintiff returned to work. On February 8, 2010, Optimum sent the plaintiff a letter advising that her income replacement benefits had been discontinued as of June 28, 2009 and attached an Explanation of Benefits form.

On February 15, 2011, the plaintiff stopped working as a result of the injuries she sustained in the collision. She filed a Disability Certificate on July 11, 2012 and on July 13, 2012, the plaintiff requested that Optimum reinstate her income replacement benefits effective February 15, 2011.

On July 20, 2012, Optimum denied this request on the basis that the plaintiff was past the limitation period to dispute the benefits, which was February 8, 2012. The plaintiff argued the limitation period was July 20, 2014. After the plaintiff commenced an action for the denied benefits, Optimum brought a summary judgment motion.

At first instance, Justice Arrell allowed the motion. Justice Arrell stated he was bound by the Ontario Court of Appeal’s decisions in Haldenby v. Dominion and Wadhwani v. State Farm which reasoned that allowing a temporary return to work within the initial period to extend a limitation period would in effect extend a claimant’s entitlement to benefits for an indeterminate period of time. This is inconsistent with the Supreme Court of Canada’s rationale which underlined the common sense of, and the need for limitation periods and controverts the systemic need for finality, certainty and the principle of diligence.

The plaintiff appealed the decision. The Ontario Court of Appeal unanimously dismissed the appeal.


Read the full decision on CanLII

Karen Vigmond
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