Summary

Keywords

Limitation of actions - Equity - Limitation of actions — Discoverability — Equity — Relief from forfeiture — Insured injured in car accident in August 2014 and unable to work — Delay in filing application claim form for long term disability benefits — Insurer closing file in June 2015 — Insured filing claim forms in March 2017 once lawyers retained — Insurer denying claim in June 2017 — Insured filing court action in June 2019 — Motion judge dismissing insurer’s motion for summary judgment — Court of Appeal reversing and dismissing insured’s action as being statute-barred — When do plaintiffs discover an insurance claim in Canada? — Absent a denial of coverage, do limitations periods commence before an insured requests indemnity by filing the appropriate proof of loss forms? — If a court grants relief from forfeiture for an insured’s acts or omissions constituting imperfect compliance with an insurance contract, can those acts trigger the commencement of the limitation period? — How does s. 5(1)(a)(iv) of the Ontario Limitations Act, 2002, and its analogues across Canada, affect the discoverability analysis? — When can courts consider whether a claim was clearly and unequivocally denied? — Does a contractual claims process or informal appeal process under an insurance contract constitute an alternative process with a reasonably certain or ascertainable date on which it runs its course or is exhausted such that it is not appropriate to commence a proceeding? — Limitations Act, 2002, S.O. 2002, c. 24, Schedule B, s. 5.

Summary

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The applicant, Kamalavannan Kumarasamy, was injured in a car accident in August 2014; he has been unable to work since that time. Mr. Kumarasamy was late in filing a notice of claim for long-term disability (“LTD”) benefits with his insurer, the respondent Western Life Assurance Company (“Western”). Mr. Kumarasamy never received Western’s letters asking him to file LTD claim forms; having received no such forms, Western advised Mr. Kumarasamy in June 2015 that it was closing his claim file. In October 2016, Mr. Kumarasamy’s lawyers, though not yet retained for a potential LTD claim, wrote to Western and requested a copy of the claim file; Western responded by confirming that the file had been closed. In February 2017, Mr. Kumarasamy signed a retainer with his lawyers for his LTD claim. Further correspondence was exchanged in March 2017, including the sending of Mr. Kumarasamy’s completed LTD claim forms to Western. In June 2017, Western wrote to Mr. Kumarasamy and his lawyers, advising him that his LTD claim was denied, given the delay in filing his notice of claim. An internal appeal from this refusal of coverage was also denied. In June 2019, Mr. Kumarasamy’s lawyers issued a statement of claim against Western; in response, Western filed a motion seeking summary judgment.

The Ontario Superior Court of Justice dismissed Western’s motion for summary judgment, finding that Mr. Kumarasamy’s action was not statute barred by Ontario’s Limitations Act, 2002. The Ontario Court of Appeal allowed Western’s appeal, granted its motion for summary judgment, and dismissed Mr. Kumarasamy’s action against Western as being statute barred.