Ontario: limitation period in Teacher’s Life policy invalid

In Parmar v. Teachers Life, Justice Faieta held that the limitation period in Teachers Life’s “Educators Income Protection Plan and Policy” doesn’t apply to a claim for denial of coverage under the policy.  Instead, the Limitation Act‘s basic two-year limitation applies:

[32]           The defendant submits that this action is barred by the two-year limitation period found in Policy.  The relevant provision, at p. 50 of the Policy, states:

In the case where benefits have not been paid or have been paid on a without prejudice basis, a legal proceeding shall not be commenced in respect to a claim under this policy after the second anniversary of the day the claim was discovered.  Discovery of a claim shall be defined as the earlier of the date a claim was first filed with Teachers Life, or the day a reasonable person ought to have known that a claim for benefits should have been filed with Teachers Life. [Emphasis added.]

[33]           However, the Act provides that a limitation period under the Act applies despite any agreement to vary or exclude it unless (1) such agreement was made before January 1, 2004; or (2) it is a “business agreement”, among other exceptions: see s. 22 of the Act.  I find that neither exception applies.

[34]           First, the Policy states that it was revised September 1, 2009 and “replaces all previous polices issued for Plan holders who are not currently receiving Disability Benefits”: see Policy, at p. 2.  Accordingly, I find that the Policy was not made before January 1, 2004.

[35]           Second, the Policy names (1) the defendant as the insurer; (2) the Ontario Secondary School Teachers’ Federation, District 12, as the Plan Sponsor; and (3) the individual member as the Policyholder.  I find that the Policy is not a “business agreement” because (1) the plaintiff is a party to the Policy; and (2) the Policy was made for “personal, family or household purposes”: see Kassburg v. Sun Life Assurance Company of Canada, 2014 ONCA 922 (CanLII), at paras. 58-61.  Accordingly, the limitation period provision found in the Policy, including the trigger for the discovery of a claim, has no effect.