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Insurance - Auto - Notice (2). Traders General Insurance Company v. Rumball
In Traders General Insurance Company v. Rumball (Ont Divisional Ct, 2025) the Divisional Court dismissed an insurer's JR, here from an adjudicator's decision that the respondent "is not barred from appealing Traders’ denial of her claim for income replacement benefits (“IRBs”) by the two year limitation period under section 56 of the Statutory Accident Benefits Schedule – Effective September 1, 2010, O. Reg. 34/10, as amended (“SABS”) because Traders’ letter dated March 4, 2015 was not a clear and unequivocal denial of IRBs.":[36] An insurer must provide “clear and unequivocal” notice denying or cancelling the insured’s benefits to trigger the two-year limitation period: Sietzema v. Economical Mutual Insurance Company, 2014 ONCA 111, 118 O.R. (3d) 713, at para. 13, leave to appeal refused, 2014 CanLII 68702 (SCC). Given the consumer protection purpose of the Insurance Act and the SABS, such notice must be in “…straightforward and clear language, directed towards an unsophisticated person”: Smith v. Co-operators General Insurance Co., 2002 SCC 30, [2002] 2 S.C.R. 129, at para. 14. The case involves a close-read and close-reasoning of this particular insurer's extensive notice letter text [paras 4-7, 37-39], which may be useful to anyone facing a similar issues.
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