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 of benefits.
Lerners Insurance Defence Reference Library
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