Uy v. Great-West Life Assurance Co.,  O.J. No. 5216, Ontario Superior Court of Justice
The Defendant (“GWL”) brought a motion for Summary Judgment against the Plaintiff. GWL offered services to employers as a disability insurance manager. At all material times, GWL and IBM Canada Ltd. (“IBM”) were bound by an Adjudication Only Agreement. Pursuant to the Agreement, GWL agreed to provide adjudication services for IBM’s self-insured disability plans. GWL had no liability to pay benefits to IBM employees under the Agreement. GWL’s role in the Agreement was to receive, consider, and adjudicate claims presented to it as administrator and agent on behalf of IBM in respect to its employees’ disability claims.
The Plaintiff had submitted claims for benefits to GWL. The Plaintiff received benefits for a specified period and they were then cut off. She was eventually terminated from her employment and executed a Release in favour of IBM and its agents.
The Plaintiff argued that she did not know that GWL was effectively an administrator or agent for IBM. She believed that GWL was operating as her Insurer independently of IBM. She therefore commenced an action against GWL for the damages for breach of contract.
The court held that it was clear that GWL was intended to be included in the group that received the benefit of the Release executed by the Plaintiff. GWL was clearly acting as an administrator for IBM. The Release was clear and GWL was entitled to the benefit of the Release. Therefore, the Plaintiff was estopped from bringing any claim against GWL arising out of her employment with IBM. Although the Plaintiff believed otherwise, the court held that IBM was the Insurer of her disability plan and had exclusive liability for the payment of benefits under the plan. At all times, the Plaintiff’s contract for disability benefits was with IBM, not GWL. GWL was never the Insurer of the Plaintiff and the Plaintiff therefore did not have a tenable claim against GWL. Accordingly, GWL’s motion for Summary Judgment was granted and the Plaintiff’s action was dismissed.
To stay current with the new case law and emerging legal issues in this area, subscribe here.