The recent Supreme Court of Canada Ruling Sabean v. Portage La Prairie Mutual Insurance Co. represented a win for accident victims. The unanimous seven-judge decision from the nations top court held that the CPP is not a policy of insurance, and that the insurer cannot deduct a NS man’s CPP disability payments from his insurance payments according to the provinces SEF 44 endorsement. In Ontario, this is known as the OPCF-44R.
This is a standard endorsement better known as the family protection endorsement allowing insurance companies to deduct future payments from other polices of insurance that ‘provide disability benefits’. It’s meant to cover drivers injured in car accidents and crashes caused by uninsured drivers, but has been used by insurance companies to reduce payments to injured parties.
Insurers have long argued that CPP should be considered an insurance policy, however, the Supreme Court held in its written decision that the plain reading of the legislation is that laypeople understand the endorsement to mean ‘an optional, private insurance contract and not a mandatory scheme such as the CPP.’
There has been a trend in Ontario since 2010 that has seen the steady erosion of the accident benefit system. Since 2016 CAT benefits were reduced from $2 million to $1 million, and those non-catastrophically injured have seen significant reductions to benefits as well. At Deutschmann Law we have seen the very sad situation that exists now. People are forced to battle insurance companies for even basic benefits, and some of our clients have realized too late that they don’t have adequate coverage for their injuries.
The judgement makes it clear that insurance companies have an advantage over consumers because they know the legislation and jurisprudence much better than the average consumer. In order to level the playing field, “the overriding principle is that where the language of the disputed clause is unambiguous, reading the contract as a whole, effect should be given to that clear language,” according to the Supreme Court.