Leblanc et al. v. London Life Insurance Co., (1999) 102 O.T.C. 1 (SC)

• Judge: Pardu, J.
• Court: Superior Court of Justice of Ontario (Canada)
• Case Date: August 24, 1999
• Jurisdiction: Ontario
• Citations: (1999), 102 O.T.C. 1 (SC)

Leblanc v. London Life (1999), 102 O.T.C. 1 (SC)

MLB headnote and full text

Temp. Cite: [1999] O.T.C. TBEd. SE.085

Marie Leblanc and 724075 Ontario Limited (plaintiffs) v. London Life Insurance Company (defendant)

(File No. C-227/94)

Indexed As: Leblanc et al. v. London Life Insurance Co.

Court of Ontario

Superior Court of Justice

Pardu, J.

August 24, 1999.

Summary:

The female plaintiff claimed disability benefits under a group insurance contract on the basis that she was "totally disabled" by reason of her fibromyalgia. The defendant insurer denied the claim on the ground that the plaintiff was not "totally disabled" within the meaning of the policy and that she failed to disclose material facts relating to her medical history. Should the insurer be liable to pay the benefits, the quantum of benefits was also in dispute.

The Ontario Superior Court allowed the action. The plaintiff was "totally disabled" within the meaning of the policy. The plain­tiff clearly misstated her medical history by failing to disclose pre-existing conditions. The issue was whether the information not disclosed was material in the sense that the insurer would have denied coverage or required a higher premium to compensate for the higher risk. The court held that material facts were not disclosed, but the insurer was not entitled to rely on the nondisclosure to invalidate the policy where the insurer was already aware of these facts. The non-dis­closed facts the insurer was unaware of were not material. The plaintiff was entitled to benefits. The court also awarded the plaintiff $10,000 damages for mental distress, but dismissed a claim for punitive damages.

Damages - Topic 1305.1

Exemplary or punitive damages - Insur­ance claim denial - See paragraphs 68 to 69.

Damages - Topic 1532

General damages - Elements of general damages - Mental distress or emotional upset - See paragraphs 63 to 67.

Insurance - Topic 2442

Applicant's duty of disclosure - Materiality - Facts known to applicant - See para­graphs 1 to 48.

Insurance - Topic 2444

Applicant's duty of disclosure - Materiality - Matters not material - See paragraphs 1 to 48.

Insurance - Topic 2446

Applicant's duty of disclosure - Materiality - Material matters - See paragraphs 1 to 48.

Insurance - Topic 2502

Applicant's duty of disclosure - Excuse for nondisclosure - Facts which insurer knows or ought to know - See paragraphs 1 to 48.

Insurance - Topic 3570

Accident and sickness insurance - The contract - Interpretation of terms - Total disability defined - See paragraphs 1 to 48.

Cases Noticed:

Vrbancic v. London Life Insurance Co. (1995), 83 O.A.C. 321; 25 O.R.(3d) 710 (C.A.), refd to. [para. 26].

Henwood v. Prudential Insurance Co. of America, [1967] S.C.R. 720, refd to. [para. 30].

Blouin v. Maritime Life Assurance Co. (1988), 88 N.S.R.(2d) 23; 225 A.P.R. 23 (T.D.), refd to. [para. 31].

Silva v. Sizoo et al. (1997), 48 O.T.C. 347 (Gen. Div.), refd to. [para. 32].

Stone v. Reliance Mutual Insurance Soci­ety, [1972] 1 Lloyd's Rep. 469, refd to. [para. 33].

Blanchette v. C.I.S. Ltd., [1973] S.C.R. 833, refd to. [para. 33].

Canadian Indemnity Co. v. Canadian Johns-Manville Co., [1990] 2 S.C.R. 4549; 115 N.R. 161; 33 Q.A.C. 161, refd to. [para. 37].

Coronation Insurance Co. et al. v. Taku Air Transport Ltd. et al., [1991] 3 S.C.R. 622; 131 N.R. 241; 6 B.C.A.C. 161; 13 W.A.C. 161, refd to. [para. 38].

335445 Alberta Ltd. v. Transamerica Life Ltd., [1996] I.L.R. 1-3345, refd to. [para. 39].

Vorvis v. Insurance Corp. of British Columbia, [1989] 1 S.C.R. 1085; 94 N.R. 321, refd to. [para. 63].

Jarvis v. Swans Tours Ltd., [1973] 1 Q.B. 233 (C.A.), refd to. [para. 63].

Wallace v. United Grain Growers Ltd., [1997] 3 S.C.R. 701; 219 N.R. 161; 123 Man.R.(2d) 1; 159 W.A.C. 1, refd to. [para. 63].

Beaird v. Westinghouse Canada Inc. (1999), 118 O.A.C. 120; 43 O.R.(3d) 581 (C.A.), refd to. [para. 64].

Warrington v. Great-West Life Assurance Co. (1996), 81 B.C.A.C. 164; 132 W.A.C. 164; 139 D.L.R.(4th) 18 (C.A.), refd to. [para. 66].

Thompson v. Zurich Insurance Co. (1984), 7 D.L.R.(4th) 664 (Ont. H.C.), refd to. [para. 66].

Whiten v. Pilot Insurance Co. et al. (1999), 117 O.A.C. 201; 42 O.R.(3d) 641 (C.A.), refd to. [para. 68].

Counsel:

Charles C. Conroy, for the plaintiffs;

D. Los and J. Bradford, for the defendant.

This action was heard on June 7-11, 14-18, 23-25 and 28-29, 1999, before Pardu, J., of the Ontario Superior Court, whose following judgment was released on August 24, 1999.