Parmar v. Teachers Life, 2017 ONSC 2329

• Laura Camarra


• 26 Apr 2017

The Plaintiff commenced an action for payment of disability benefits from the Defendant. The Defendant brought a motion for summary judgment, arguing the action was barred by the policy and/or the Limitations Act. The Court granted the Defendant’s motion for summary judgment.

Released April 13, 2017 | Full Decision [CanLII]

The facts of the case are straightforward:

• The Plaintiff, a teacher, suffered a workplace assault on February 5, 2010. He never returned to work after the assault and was diagnosed with post-traumatic stress disorder, depression and anxiety. He received loss of earnings benefits from the WSIB until November 25, 2011. He was insured under the Defendant’s “Educators Income Protection Plan and Policy” (the policy).
• Under the policy, he was eligible to receive disability benefits starting on January 1, 2012, provided he satisfied the terms of the policy. The Plaintiff applied for short-term disability benefits on January 30, 2012.
• A claims examiner wrote to the Plaintiff on February 9, 2012, requesting information to assess his claim. On February 29, 2012, the claims examiner also wrote to the WSIB, requesting a copy of their file. The Plaintiff retained a paralegal, who wrote to the claims examiner on April 23, 2012, refusing their request for the WSIB file. Counsel for the Defendant responded, by letter dated April 25, 2012, indicating the refusal to produce the WSIB file constituted a breach of the policy. By letter dated April 30, 2012, the paralegal maintained the Plaintiff’s position. By letter dated May 9, 2012, counsel for the Defendant wrote to the paralegal, indicating if compliance was not effected within 14 days from the date of the letter, the claim would receive no further consideration.
• The Plaintiff contacted the insurer on September 12, 2014, to enquire as to the status of his claim. The insurer wrote to the Plaintiff on September 15, 2014, confirming his claim had been closed following the insurer’s May 9, 2012 letter to him, as the insurer had not received the requested information from the Plaintiff or his representative.
• The Plaintiff contends he became aware his application for benefits was denied on September 15, 2014. The Plaintiff commenced an action on October 6, 2015.

The Court reviewed the relevant jurisprudence in determining a motion for summary judgment. In Hryniak v. Mauldin, 2014 SCC 7, para. 49, the Court stated:

There will be no genuine issue requiring a trial when the judge is able to reach a fair and just determination on the merits on a motion for summary judgment. This will be the case when the process (1) allows the judge to make the necessary findings of fact, (2) allows the judge to apply the law to the facts, and (3) is a proportionate, more expeditious and less expensive means to achieve a just result.

Rule 20.04(2.1) provides that in determining whether there is a genuine issue requiring a trial, the Court shall consider the evidence submitted by the parties, and the judge may exercise any of the following powers for the purpose, unless it is in the interest of justice for such powers to be exercised only at trial:

1. Weighing the evidence.
2. Evaluating the credibility of a deponent.
3. Drawing any reasonable inference from the evidence.

The Court reiterated a responding party may not rest solely on the allegations or denials in the party’s pleadings, but must set out, in affidavit material or other evidence, specific facts showing there is a genuine issuing requiring a trial. Each side must “put its best foot forward” with respect to the existence or non-existence of material issues to be tried (see Papaschase Indian Band No. 136 v. Canada (Attorney General), 2008 SCC 14). A Court is entitled to assume the record contains all the evidence the parties would present if the matter proceeded to trial.

The Court found the Defendant was not entitled to rely on the limitation period set out in the policy. The Limitations Act provides that a limitation period under the Act applies despite any agreement to vary or exclude it unless (1) such agreement was made before January 1, 2004; or (2) it is a “business agreement”, among other exceptions. The Court found neither exception applied. The policy was revised September 1, 2009 and “replaces all previous policies issued for Plan holders who are not currently receiving Disability Benefits”.

Turning to whether the action was commenced outside the Limitations Act, the Court noted the knowledge of a person’s solicitor is imputed to that person (see Pepper v. Sanmina-Sci Systems (Canada) Inc., 2017 ONSC 1516). The Court found the principle applies to the analogous relationship of paralegal/client.

The Court found the May 9, 2012 letter constituted a denial by the Defendant of the Plaintiff’s claim, albeit using somewhat ambiguous language. “Although the Defendant’s letter might have more plainly communicated a denial of the Plaintiff’s application by simply using those words and describing the appeal rights under the Policy, I find that the language used reasonably communicated a clear and unequivocal denial of the application”. The limitation period began to toll on May 23, 2012, 14 days after the date of the letter.

Read the Full Decision on CanLII