The Court of Appeal's recent decision in Sagan v. Dominion [2014 ONCA 720]
confirmed that the submission of Disability Certificates are not
required to trigger the commencement of a limitation period.
In this case, the Plaintiff was injured in a motor vehicle
accident in March 2008. Mr. Sagan filed an Application for Accident
Benefits (that included a claim for non-earner benefits) but did
not file a Disability Certificate. The Insurer denied the
Non-Earner Benefits Claim in April 2008. The Plaintiff filed for
mediation in April 2011.
The motion Judge granted the Insurer's motion for summary
judgment and found that the limitation period had expired. On
appeal, Mr. Sagan took the position that the time did not start to
run until there was a denial of a valid claim. The Plaintiff
relied on section 35(2) of the Statutory Accident Benefits Schedule
(SABS) which stated:
An Insured person who applies for
a specified benefit shall submit with the application a disability
certificate completed no later than 10 business days before the
date the application is submitted.
The Plaintiff argued that a valid claim required the submission
of a Disability Certificate. Since Mr. Sagan did not submit a
Disability Certificate, the limitation period had not been
triggered. The Court of Appeal rejected this argument on two
grounds. First, a plain reading of section 35(2) provided that the
Disability Certificate is to be filed with the Application
for Benefits. It was not the application. Second, the SABS was
designed to ensure timely submission and resolution of accident
benefits. The Court of Appeal held that it was not in keeping with
this purpose to suggest that a Claimant can delay the start of a
limitation period by not submitting a Disability Certificate.
Over the last several years, there have been numerous attempts
by Plaintiff Counsel to delay or set aside the commencement of a
limitation period in a claim for accident benefits. The Court of
Appeal has once again upheld the expiry of a limitation and
rejected a novel argument that both an Application for Accident
Benefits and a Disability Certificate are required for a valid
claim for non-earner benefits to arise. In most circumstances, the
Insurer should be able to argue that the limitation period expires
two years from the date of a clearly worded denial or termination
In an October 3, 2016 preliminary issue hearing Adjudicator Marzinotto of the License Appeal Tribunal allowed an applicant to proceed to a hearing disputing both entitlement to Income Replacement Benefits and Non Earner Benefits.
On August 4, 2016, the Ontario Court of Appeal released its decision in Intact v. Allstate and changed the correctness standard of review for appeals from private arbitrations to one of reasonableness.
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