Industry giant forced to pay up after appeal denied.
Sun Life Assurance was forced to pay $15,000 to a member of the North Bay Police Service after an Ontario court dismissed its appeal.
On Oct. 22, 2007, Karren Kassburg stopped working, allegedly due to physical and psychological disabilities. In April 2008, five months before the expiry of the elimination period under the policy, she submitted her long-term disability claim. Over the next two years the two parties corresponded over the claim, with Sun Life asking for more information.
Eventually, Sun Life dismissed Kassburg’s claim. Kassburg started an action claiming entitlement to the disability benefits in February 2012. Sun Life argued the action was out of time, as both the insurance contract and the Limitations Act had expired.
But the judge sided with Kassburg, finding that the contractual limitation period was ambiguous and therefore unenforceable and concluding that the statutory limitation period did not begin to run until after Kassburg had exhausted the company’s internal appeal process.
Sun Life argued the motion judge erred in those findings as well as granting judgment in favour of the respondent, and not directing to trial the issue of when the limitation period expired.
The appeal court dismissed these claims. However, it found the judge was wrong in ruling the contract between Kassburg and Sun Life as a “business agreement.” But the dismissal of the appeal rendered the cross-appeal moot, as the statutory limitation period, and not the contractual period, applies.
On Oct. 22, 2007, Karren Kassburg stopped working, allegedly due to physical and psychological disabilities. In April 2008, five months before the expiry of the elimination period under the policy, she submitted her long-term disability claim. Over the next two years the two parties corresponded over the claim, with Sun Life asking for more information.
Eventually, Sun Life dismissed Kassburg’s claim. Kassburg started an action claiming entitlement to the disability benefits in February 2012. Sun Life argued the action was out of time, as both the insurance contract and the Limitations Act had expired.
But the judge sided with Kassburg, finding that the contractual limitation period was ambiguous and therefore unenforceable and concluding that the statutory limitation period did not begin to run until after Kassburg had exhausted the company’s internal appeal process.
Sun Life argued the motion judge erred in those findings as well as granting judgment in favour of the respondent, and not directing to trial the issue of when the limitation period expired.
The appeal court dismissed these claims. However, it found the judge was wrong in ruling the contract between Kassburg and Sun Life as a “business agreement.” But the dismissal of the appeal rendered the cross-appeal moot, as the statutory limitation period, and not the contractual period, applies.
