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Administrative - Estoppel. Davis v. Aviva General Insurance Co. [estoppel by representation]
In Davis v. Aviva General Insurance Co. (Div Court, 2024) the Divisional Court allowed an insured's LAT SABS appeal, here where the insurer paid several years of claims, but then successfully denied coverage on the basis that there was no 'accident'.
The court turns to the issue of whether the LAT has equitable jurisdiction, here while examining the insured's 'estoppel' (an equitable principle) argument against the insurer for it's late assertion of a denial of coverage. The court finds that the LAT does have equitable jurisdiction, though it does not apply it here on the facts of the case [this latter at paras 67-68]:[55] .... On this ground of appeal, Ms. Davis takes the position that Aviva’s acceptance of her application for benefits and conferencing those benefits that had been denied over two years later without reference to whether she had been injured in an “accident” raised a form of estoppel. Ms. Davis is effectively arguing that time is on her side. She is arguing that the LAT has equitable powers it should have used to deny Aviva’s motion, and that its failure to use those powers was an error of law.
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[65] Adjudicator Norris reached this conclusion on the basis that the SABS does not prohibit or preclude the LAT from exercising this power. This reasoning was augmented by his observation that the Supreme Court held as early as 2002 in Smith v. Co-operators General Insurance Co., 2002 SCC 30, [2002] S.C.R. 129, that one of the main objectives of the SABS is to provide consumer protection. In Botbyl, Adjudicator Norris agreed with the submission of the applicant that permitting the LAT to grant equitable relief is consistent with that objective.
[66] There is persuasive authority for me to find that an adjudicator has the discretion to exercise equitable powers where it is just to do so on an application. These powers are available to ensure procedural fairness, in keeping with the objectives set out for administrative decision-makers in Baker.
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