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Insurance - Auto - Notice (2). Sparks v. Primmum Insurance Company
In Sparks v. Primmum Insurance Company (Div Ct, 2026) the Divisional Court dismissed a SABS claimant's appeal/JR, here brought against a LAT decision "which found that the respondent insurer’s notice informing Mrs. Sparks of her right to dispute the partial denial of her application for benefits under the SABS complied with the requirements under section 54 of the SABS and thereby triggered the commencement of the two-year limitation period under s. 56 of the SABS of her application":[1] Section 54 of the Statutory Accident Benefits Schedule – Effective September 1, 2010, O. Reg. 34/10 (“SABS”) states that if an insurer refuses to pay a benefit, then the insurer shall provide the person with a written notice advising the person of his or her right to dispute the refusal or reduction.
[2] Under s. 56 of the SABS an application under section 280(2) of the Insurance Act, R.S.O. 1990, c. I.8 (“Insurance Act”), in respect of a benefit shall be commenced within two years after the insurer’s refusal to pay the amount claimed.
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[12] The question of whether the notice provided by the insurer to Ms. Sparks complies with the requirements of section 54 of the SABS is a question of mixed fact and law. However the dispute regarding the content of the notice required by section 54 of the SABS raises an extricable question of law that is subject to the statutory appeal.
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ISSUE #1: DID THE ADJUDICATOR ERR IN FINDING THAT A NOTICE UNDER SECTION 54 OF THE SABS DOES NOT REQUIRE THAT AN INSURER NOTIFY A CLAIMANT OF EVERY STEP OF THE RECONSIDERATION AND APPEAL PROCESS, NOR PROVIDE TIMELINES AND CONTACT INFORMATION FOR THE VARIOUS COURTS?
[16] In her Decision, the Adjudicator states:[15] With respect to outlining every step of the dispute resolution and appeal process, including timelines and contact information for the various Courts, I note that s.54 of the Schedule requires that an insurer provide a written notice advising the claimant of their right to dispute the refusal. It does not mandate specifics of every step of the reconsideration and appeal process. The applicant argues that a broad and liberal interpretation of s. 54 requires that an insurer must “do much more than simply quote the act” or provide information on the first step of the process. However, the applicant has not provided any support for this position, by way of a Tribunal or Court decision.
[16] Rather the applicant argues that all of the decisions that followed Smith v. Cooperators were incorrectly decided. With respect, I disagree with the applicant’s position. I do not see anything in the Schedule or caselaw that requires that the complete chronology of the dispute resolution process be articulated to an insured in a denial letter. While the Supreme Court of Canada in Smith held that an insurer is required to inform the person of the dispute resolution process, I do not see in Smith a requirement that the entire appeal process be detailed.
[17] I further am persuaded by the decisions cited by the respondent that a denial notice is compliant if the insured person has enough information to decide whether to accept or dispute the refusal. I agree with the reasoning in 18-004416 vs. Intact Insurance Company, 2019 CanLII 34593 (ONLAT), where the Tribunal held that providing information “sufficient to trigger action by the applicant is, in my view, the key point of disclosure [of the dispute resolution process].” [17] Ms. Sparks submits that that the content of the Notice does not protect consumers as it does not inform a claimant of the opportunity to request a reconsideration under the Tribunal’s Rules, the right to appeal under the LATA and/or file an application for judicial review with the Divisional Court, the right to appeal to the Ontario Court of Appeal and then to the Supreme Court of Canada, along with information regarding all applicable timelines and contact information for the Courts.
[18] This case raises the issue of the proper interpretation of s. 54 of the SABS. In Arts (Litigation Guardian of) v. State Farm Insurance Co., 2008 CanLII 25055 (ON SC), [2008] O.J. No. 2096, R, MacKinnon, J. stated at para. 16:The SABS are remedial and constitute consumer protection legislation. As such, they are to be read in their entire context and in their ordinary sense harmoniously with the scheme of the Act, the object of the Act, and the intention of the legislature. The goal of the legislation is to reduce the economic dislocation and hardship of motor vehicle accident victims and as such, assumes an importance which is both pressing and substantial. [19] The above statement was approved by the Ontario Court of Appeal in Tomec v. Economical Mutual Insurance Company, 2019 ONCA 882, 148 O.R. (3d) 438, at para. 42.
[20] In Smith v. Co-operators General Insurance Co., 2002 SCC 30, the Supreme Court of Canada considered s. 71 of O. Reg. 776/93 which was the predecessor to s. 54 of the SABS. At time, under s. 281(1) of the Insurance Act a claimant for accident benefits that disputed an insurer’s refusal to pay benefits could commence a proceeding in a court, refer the issues to an arbitrator under s. 282, or with the insurer agree to an arbitration under the Arbitrations Act, 1991. This first step of the dispute resolution process was mediation as s. 281(2) prohibited the commencement of any such steps unless mediation had been sought and failed. Section 281(5) provided that any such step “must be taken within two years after the insurer’s refusal to pay the benefit claimed …”.
[21] Section 71 of O. Reg. 776/93 stated:If an insurer refuses to pay a benefit that a person has applied for under this Regulation or reduces the amount of a benefit that a person received under this Regulation, the insurer shall inform the person in writing of the procedure for resolving disputes relating to benefits under section 279 to 283 of the Insurance Act. [Emphasis added] [22] In Smith, the insurer notified the applicant that it had terminated accident benefits and further advised the applicant that “… you have the right to ask for mediation through the Ontario Insurance Commission. …”. The mediation was held and failed. The applicant issued a statement of claim more than two years after the insurer’s termination of benefits. The Court held that the applicant’s claim was not time-barred by s. 281(5) as no proper refusal had been made and thus the limitation period had not begun to run. The Court, at paras. 14-15, stated:In my opinion, the insurer is required under s. 71 to inform the person of the dispute resolution process contained in ss. 279 to 283 of the Insurance Act in straightforward and clear language, directed towards an unsophisticated person. At a minimum, this should include a description of the most important points of the process, such as the right to seek mediation, the right to arbitrate or litigate if mediation fails, that mediation must be attempted before resorting to arbitration or litigation and the relevant time limits that govern the entire process. Without this basic information, it cannot be said that a valid refusal has been given.
Given that s. 71 of the SABS imposes a requirement to inform the claimant of the dispute resolution process as discussed above, and given that the respondent only informed the appellant of the first step of this process, a proper refusal cannot be said to have been given. Since a proper refusal was not given, and since the limitation period under s. 281(5) of the Insurance Act only begins to run upon a refusal, that limitation period was not triggered by the notice sent on May 8, 1996. [Emphasis added] [23] Before April 1, 2016, the Financial Services Commission of Ontario (“FSCO”) was empowered to resolve statutory accident benefits disputes through mediation and then arbitration. Under the Insurance Act, a claimant who wished to dispute the refusal of an application for accident benefits was required to attend mediation. If mediation failed, a claimant could commence a court proceeding, or refer the dispute to an arbitration at FSCO, or with the agreement of insurer, submit the dispute to any person for arbitration under the Arbitration Act, 1991.
[24] Amendments to the Insurance Act that took effect on April 1, 2016, simplified the dispute resolution by eliminating mediation, litigation and private arbitration as avenues for disposition. The process to dispute accident benefits now only requires that the claimant submit an application to the Tribunal to hear the dispute.
[25] To reflect the current dispute resolution process, se. 71 of O. Reg. 776/93 was replaced with s. 54 of the SABS which states:If an insurer refuses to pay a benefit or reduces the amount of a benefit that a person is receiving, the insurer shall provide the person with a written notice advising the person of his or her right to dispute the refusal or reduction. [Emphasis added] [26] Ms. Sparks submits that, given its language, the notice requirements under s. 54 of the SABS is broader than its predecessor, s. 71 of O. Reg. 776/93. She submits that the scope of the notice required by section 71 was limited to dispute resolution process at FSCO rather than the entire dispute resolution process available to an insured. As such the “guardrails” on the notice created by the phrase “procedure for resolving disputes relating to benefits under section 279 to 283 of the Insurance Act” are not found in s. 54 of the SABS with the result that the notice “must encompass every level of dispute process, including appeals and judicial reviews to the Court”.
[27] There is little merit to this submission.
[28] In advocating for the inclusion of a description of all possible avenues of reconsideration, appeal and review, Ms. Sparks overstates the effect of the consumer protection purpose of the SABS given the clear and unambiguous language in s. 54 of the SABS.
[29] Section 54 only requires an insurer to provide notice of the “right to dispute the refusal …” The only “right to dispute the refusal” to pay accident benefits is found in s. 280(2) of the Insurance Act which states that a claimant may apply to the Tribunal to resolve a dispute. The availability of reconsideration under the LATA and the avenues for appeal and judicial review do not amount to a “right to dispute” the insurer’s refusal to pay accident benefits but rather represent a right to dispute an Adjudicator’s decision or a Court’s decision that follow an insurer’s refusal to pay accident benefits. The absence of the so-called “guardrails” on s. 54 does not change this analysis.
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[33] Given that the Adjudicator accepted the Insurer’s reasoning, I repeat the Insurer’s submissions to the Adjudicator on this point:.... the purpose of the notice requirement is to ensure whether the person has enough information to decide whether to accept or dispute the refusal and to trigger action. The additional information, including … information on discoverability ands. 7 of the LAT Act, holds the respondent to a standard of perfection that the Court of Appeal in Turner [Turner v. State Farm Mutual Automobile Insurance Co., 2005 CanLII 2551 (ON CA), [2005] O.J. No. 351 (C.A.) ] determined was not required. [Emphasis added] [34] The Adjudicator erred in their description of the purpose of s.54 of the SABS by relying on Turner. Turner is distinguishable. That case did not deal with an insurer’s obligation to provide notice of a claimant’s right to dispute an insurer’s refusal to pay benefits. A different obligation to provide notice was addressed. The issue in Turner was whether the insurer had given sufficient reasons for cancelling accident benefits under s. 24(8) of the SABS as it then existed. The Ontario Court of Appeal held that the notice was sufficient to trigger the limitation period even if the reasons were not legally correct.
[35] As explained in Turner, at para. 8, the purpose of the notice of the requirement under s. 24(8) of the SABS may have been to ensure that a claimant has enough information to decide whether or not to dispute the refusal, whereas the purpose of notice under s. 54 of the SABS is to “completely and clearly provide insured persons with the information needed to enable them to challenge the refusal to pay or the reduction of payment”: Smith, para. 9.
[36] The obligation under s. 54 of SABS for an insurer to provide “… written notice advising the person of his or her right to dispute the refusal …” of a claim for accident benefits requires an insurer to provide information on how and where to file a dispute but also when to file a dispute. The Notice addressed how, where and when to file a dispute. Information about when to file a dispute does not require an insurer to meet a standard of perfection but simply meet the standard expressed in Smith, at para. 14, that information about “the relevant time limits that govern the entire [dispute] process” is required to be provided by an insurer.
[37] Ms. Sparks submits that the statement in the Notice that she “will” lose the right to dispute the insurer’s denial of her claim for accident benefits if she does not file an application with the Tribunal within 2 years of the date of the refusal to pay accident benefits is incorrect and misleading.
[38] The Insurer disputes that the 2 year time limit under s. 56 of the SABS is subject to the principle of discoverability as outlined in Tomec v. Economical Mutual Insurance Company, 2019 ONCA 882. However, this point was settled by the Ontario Court of Appeal in The Personal Insurance Company v. Tagoe, 2024 ONCA 894. At paragraph 18, the Ontario Court of Appeal states:As a starting point, we accept TPIC’s concession that the discoverability rule applies to IRB claims. Claims for SABS benefits, whether during the 104 weeks after an accident or later, are now both subject to the two-year limitation period in s. 56 of the SABS. This provision is essentially similar to the former s. 51(1), which this court held in Tomec did not establish a hard limitation period. [Emphasis added] [39] The Insurer suggests that no harm would come from telling a claimant that there is a hard two-year limit on filing an application.
[40] While the application of the discoverability principle to an accident benefit claim may infrequently postpone the commencement of the two-year limitation period, there are circumstances where it has had such effect such as a case where the injuries from an accident become worse over time after an initial denial of a claim: See Pena v. Allstate Insurance Company of Canada, 2021 CanLII 117443.
[41] The Insurer further submits that Ms. Sparks’ proposed language for a s. 54 notice would be confusing and cause more harm than good. That may be the case, however, the obligation rests with an insurer under s. 54 to communicate in straightforward and clear language that communicates that a claim for accident benefits must be filed within two years from the date of denial. Just as it is not incumbent on the insurer to advise of the complete course of potential reviews and appeals that could be sought from a LAT decision, it is not incumbent on an insurer to brief a claimant on principles of limitations law. If it was thought that advising a claimant that claims “may” be barred, rather than that they “will” be barred if the two-year deadline is not met, the information might be considered more complete and accurate, but it would run the risk of misleading some claimants into thinking that there is a flexibility to the limitation period that does not, in fact, exist. To provide a more detailed explanation of the principles of discoverability and tolling of limitation periods would detract from the clarity of the warning. When it is recalled that the limitation period commences with the denial of the claim – which is the very same document that includes the deadline to dispute the claim – the risk of confusion should be evident. I would conclude that the LAT’s decision meets the consumer protection goal of s. 54, and that the alternatives proposed by the Appellant do not meet those goals as effectively.
[42] Although the Adjudicator erred in her reliance on Turner, it was reasonable for the Adjudicator to find that the Insurer’s Notice complied with the requirements of section 54 of the SABS. . Muddapati v. Primmum Insurance Company
In Muddapati v. Primmum Insurance Company (Ont Div Ct, 2026) the Ontario Divisional Court dismissed an appeal, this brought against "a preliminary issue decision of the Licence Appeal Tribunal .... in which the Tribunal found that she was barred from proceeding with her application by the doctrine of res judicata".
The court considers a disputed 'notice' issue, here regarding whether the insurer provided adequate notice "that it was not paying for the benefits claimed because her impairment fell within the MIG" [SABS 34/10 - s.38 'Claim for Medical or Rehabilitation Benefits']:Did the Tribunal err in finding res judicata applied despite the requirements of s. 38(9)?
[11] The appellant submits s. 38(9) of the SABS required the insurer to provide her with specific notice, in the letters sent in response to the treatment plans, that it was not paying for the benefits claimed because her impairment fell within the MIG. She relies on s. 38(11) of the SABS to say that, in the absence of a compliant notice, the respondent could not take the position she was in the MIG and was required to pay for the benefits claimed until it provided a compliant notice.
[12] I disagree with the appellant’s position. There is no question that s. 38(9) requires the insurer to provide the insured with notice of its belief that the person’s impairment falls within the MIG. The insurer’s initial notice obligation in response to a treatment plan is set out in s. 38(8). That provision requires the insurer, within 10 days of receiving a treatment plan, to give notice of which benefits it agrees to pay for, which it does not, and the reasons why it considers the denied benefits not to be reasonable and necessary. Subsection 38(9) then deals with notice that the insurer believes the insured falls within the MIG. It states:38(9) If the insurer believes that the Minor Injury Guideline applies to the insured person’s impairment, the notice under subsection (8) must so advise the insured person. [13] Subsection 38(11) sets out the consequences if the insurer fails to give the notice required by subsection (8). It states:(11) If the insurer fails to give a notice in accordance with subsection (8) in connection with a treatment and assessment plan, the following rules apply:1. The insurer is prohibited from taking the position that the insured person has an impairment to which the Minor Injury Guideline applies.
2. The insurer shall pay for all goods, services, assessments and examinations described in the treatment and assessment plan that relate to the period starting on the 11th business day after the day the insurer received the application and ending on the day the insurer gives a notice described in subsection (8). [14] The appellant relies on subsections (9) and (11) to say the respondent did not give notice that it believed the appellant was within the MIG and, therefore, it was prohibited from taking that position.
[15] The problem with the appellant’s position in the circumstances of this case is there is no dispute that the respondent did give the appellant notice of its view that the appellant’s impairment fell within the MIG, well before the treatment plans in dispute. In addition, it pursued this position when the appellant first applied to the Tribunal. As set out above, the Tribunal agreed that the appellant’s injuries fell within the MIG.
[16] The appellant relies on Zheng v. Aviva Insurance Co. of Canada, 2018 ONSC 5707 to say this initial notice was not sufficient. She argues the insurer was required to give notice about the MIG each time it responded to a treatment plan. But Zheng does not deal with a situation where the insurer previously complied with s. 38(9) and maintained that position before the Tribunal. The appellant has not provided any authority for the proposition that the insurer must provide repeated notices of its position under s. 38(9) when that position has not changed.
[17] The purpose of the MIG, as set out in Zheng, is to establish a treatment framework for an insured who has sustained a minor injury. It permits an insured immediate access to medical treatment without insurer approval and is intended to provide speedy access to rehabilitation for persons with minor injuries: Zheng, at para. 12. Section 38 of the SABS, by contrast, establishes a procedure to apply for benefits other than those payable under the MIG.
[18] In the current case, the appellant had already received benefits to the MIG limit by the time she submitted the treatment plans in dispute. There was no issue with obtaining immediate access to treatment. The insurer therefore obtained a medical report following an insurer examination to determine whether anything had changed that would mean the non-MIG provisions of the SABS would apply. It concluded they did not. The appellant has not persuaded me that s. 38 should be read as requiring an additional notice from the insurer in a situation where the MIG benefits have been exhausted and the insurer has not changed its position that the insured’s injuries fall within the MIG.
[19] I do not see any basis to interfere with the adjudicator’s rejection of the submission that s. 38(9) provided a reason to waive res judicata in this case. . Derenzis v. Gore Mutual Insurance Co.
In Derenzis v. Gore Mutual Insurance Co. (Div Ct, 2025) the Divisional Court dismissed a LAT SABS joint appeal-JR (Yatar), here where an issue was the admission in evidence of allegedly privileged affidavit "information and internal Tribunal documents that the affiant obtained as a Tribunal adjudicator".
Here the court considers the adequacy of insurer notices for required medical examinations (for eligibility) [under SABS s.44 'Examination required by insurer']:[11] Section 44 of the SABS provides in part:Examination required by insurer
44. (1) For the purposes of assisting an insurer to determine if an insured person is or continues to be entitled to a benefit under this Regulation for which an application is made, but not more often than is reasonably necessary, an insurer may require an insured person to be examined under this section by one or more persons chosen by the insurer who are regulated health professionals or who have expertise in vocational rehabilitation.
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(5) If the insurer requires an examination under this section, the insurer shall arrange for the examination at its expense and shall give the insured person a notice setting out,
(a) the medical and any other reasons for the examination;
(b) whether the attendance of the insured person is required at the examination;
(c) the name of the person or persons who will conduct the examination, any regulated health profession to which they belong and their titles and designations indicating their specialization, if any, in their professions; and
(d) if the attendance of the insured person is required at the examination, the day, time and location of the examination and, if the examination will require more than one day, the same information for the subsequent days. ....
A. Adequacy of IE notices
[54] Ms. Derenzis submits that the Tribunal made errors of law in determining whether Gore Mutual’s IE notices complied with its obligations under s. 44 of the SABS.
[55] Given the “consumer protection purpose” of insurance legislation (and the SABS in particular), Ms. Derenzis argues that notices to the insured under insurance legislation are required to be in “straightforward and clear language, directed towards an unsophisticated person”: see Smith v. Co-operators General Insurance Co., 2002 SCC 30, [2002] 2 S.C.R. 129, at paras. 11, 14. In Smith, at para. 13, the Supreme Court also questioned whether a “verbatim reproduction” of the applicable legislative provisions would constitute sufficient notice to the insured. Consistent with that concern, Ms. Derenzis argues that the contents of Gore Mutual’s IE notices (which in some cases included pages of verbatim SABS provisions before setting out reasons for the IE) ran afoul of the consumer protection purpose of the SABS.
[56] In M.B. v. Aviva Insurance Canada, 2017 CanLII 87160 (Ont. LAT), at para. 26 (referred to in the IRB Decision, at para. 62), the Executive Chair Lamoureux of the Tribunal applied the consumer protection principle in interpreting s. 44(5)(a) of the SABS, which requires that the insurer’s IE notice explain the “medical and other reasons for the examination”:In my view, an insurer satisfies its obligation to provide its “[medical] and any other reasons,” whether under s. 44(5)(a) or elsewhere, by explaining its decision with reference to the insured’s medical condition and any other applicable rationale. That explanation will turn on the unique facts at hand … [but] should, at the very least, include specific details about the insured’s condition forming the basis for the insurer’s decision or, alternatively, identify information about the insured’s condition that the insurer does not have but requires. Additionally, an insurer should also refer to the specific benefit or determination at issue, along with any section of the Schedule upon which it relies. Ultimately, an insurer’s “medical and any other reasons” should be clear and sufficient enough to allow an unsophisticated person to make an informed decision to either accept or dispute the decision at issue. Only then will the explanation serve the Schedule’s consumer protection goal. [Emphasis added.] [57] Ms. Derenzis notes that the M.B. decision has been cited in subsequent Tribunal decisions, including B.M. v Unica Insurance Inc., 2020 CanLII 72512 (ON LAT), in which the Tribunal also stated, at para. 27:An insured person should not be expected to piece together “medical or other reasons” for an examination from disparate notices and correspondence, or ... to advise an insurer of deficiencies in those notices so they may be corrected. The duty to give reasoned notice rests with the insurer. [58] Applying those principles, Ms. Derenzis submits that the Tribunal erred in considering the cumulative effect of various IE notices when determining whether they were sufficient to meet the requirements of s. 44 of the SABS.
[59] Ms. Derenzis says that the Tribunal’s repeated determinations in the IRB Decision that s. 44 notices were valid when considered along with prior notices constituted an extricable error of law, subject to appeal on a correctness standard. She also argues that when considering the validity of IE notices provided in September 2018 shortly before Gore Mutual suspended IRB payments, the Tribunal was wrong in law to consider the reasons provided in an IE notice provided a year and seven months earlier on March 13, 2017 in deciding that the later notices met the requirements of s. 44. Ms. Derenzis says that doing so was an afront to the consumer protection purpose of the SABS and a direct breach of the language and object of s. 44(5)(b). She also submits that the Tribunal’s error in the IRB Decision cannot be saved by its attempts on reconsideration to recharacterize the Tribunal’s findings by stating that the adjudicator considered the adequacy of each notice individually and found each to be compliant: see IRB Reconsideration Decision, at paras 36, 39.
[60] We do not agree that Ms. Derenzis has established an error of law relating to the application of s. 44 of the SABS in this case.
[61] Consistent with Gore Mutual’s submissions, the question of whether the IE notices it provided meet the requirements of s. 44 of the SABS is a question of mixed fact and law, involving the application of s. 44 to the facts. We see no extricable legal error in the Tribunal’s analysis.
[62] When the Tribunal is determining whether an IE notice complied with s. 44, we agree with Gore Mutual that the Tribunal would be precluded from taking into account the information that the insured and their counsel had previously received from the insurer in connection with previous IE notices. As the Tribunal stated in M.B., at para. 26, the insurer’s explanation of the medical and other reasons for the examination turns on the “unique facts at hand” in each case. In 17-004358 v Economical Mutual Insurance Company, 2018 CanLII 112110 (ON LAT), at paras. 13-14, the Tribunal referred to the M.B. decision, including its reference to the “consumer protection goal” of the SABS. In Economical, at paras. 16-17, the Tribunal considered three of the insurers’ examination notices that the insured party challenged as insufficient. The Tribunal found that “sufficient notice was provided for all of the benefits in question”: Economical, at para. 15. In doing so, the Tribunal took into account related reports and forms that had been exchanged between the parties. From these documents, taken together, the Tribunal concluded that the insured had sufficient information to make an informed decision about attending the examinations.
[63] Similarly, in the IRB Decision, in determining that Gore Mutual’s IE notices met the requirements of s. 44, the Tribunal did not err in considering the course of conduct between the parties, including previous IE notices and other documents and information that Ms. Derenzis and her counsel received from Gore Mutual. We are not satisfied that Ms. Derenzis has established any basis for interfering with the Tribunal’s finding that the IE notices complied with s. 44. In any case, the Tribunal found on reconsideration that the adjudicator at first instance considered that adequacy of each IE notice and found each compliant. It was open to the Tribunal to reach that conclusion on the record before it. We see no basis to interfere. . Traders General Insurance Company v. Rumball
In Traders General Insurance Company v. Rumball (Ont Divisional Ct, 2025) the Divisional Court dismissed an insurer's JR, here from an adjudicator's decision that the respondent "is not barred from appealing Traders’ denial of her claim for income replacement benefits (“IRBs”) by the two year limitation period under section 56 of the Statutory Accident Benefits Schedule – Effective September 1, 2010, O. Reg. 34/10, as amended (“SABS”) because Traders’ letter dated March 4, 2015 was not a clear and unequivocal denial of IRBs.":[36] An insurer must provide “clear and unequivocal” notice denying or cancelling the insured’s benefits to trigger the two-year limitation period: Sietzema v. Economical Mutual Insurance Company, 2014 ONCA 111, 118 O.R. (3d) 713, at para. 13, leave to appeal refused, 2014 CanLII 68702 (SCC). Given the consumer protection purpose of the Insurance Act and the SABS, such notice must be in “…straightforward and clear language, directed towards an unsophisticated person”: Smith v. Co-operators General Insurance Co., 2002 SCC 30, [2002] 2 S.C.R. 129, at para. 14. The case involves a close-read and close-reasoning of this particular insurer's extensive notice letter text [paras 4-7, 37-39], which may be useful to anyone facing a similar issues.
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