Insurance law - Disability insurance - Total disability; Group insurance - Long term disability benefits; Limitation of actions - Running of limitation period

Time to bring claim against disability insurer started to run when insured learned or ought to have learned she was unable to work full time.

[2016] O.J. No. 4546

2016 ONSC 5252

Ontario Superior Court of Justice

August 30, 2016

T.R. Lofchik J.

The insured commenced an action against a disability insurer and the third party administrator of an employee group insurance benefit plan for a declaration that she is disabled within the meaning of the policy. She brought other claims including a claim that the employer and the insurer had a long standing policy designed to keep injured employees from claiming benefits.

The insured was injured in a motor vehicle accident. The insured's application for short‑term and eventually long‑term benefits was approved and were paid until she returned to work full time. Her file was then closed. The insured later commenced working part time and, as a result, her benefits were retroactively terminated. The insured stopped working for the employer approximately one year later and started a claim against the insurer approximately three years after that.

The insurer took the position the insured's claim was statute‑barred by the Limitation Act and brought an application for summary judgment. The Court was satisfied that the limitation period began to run when the insured discovered or ought to have discovered she was allegedly unable to work full time and therefore the claim was statute‑barred.