Broker Liable for Failing to Advise Insured of Vacancy Exclusion

An insured brought an action against his insurance broker for failing to advise him about the vacancy exclusion in his policy.  The action was allowed and the insured was awarded damages.

Cheecham v. Saskatchewan Government Insurance [2011] S.J. No. 500, August 2, 2011, Saskatchewan Court of Queen’s Bench, B. Scherman J.

The plaintiff, Mr. Roy Cheecham, brought an action against his insurer, Saskatchewan Government Insurance, and his insurance broker, Meadow North Agencies Ltd. (“Meadow North”) after coverage was denied for damage sustained to his vacant rental property. The claim against the insurer had been dismissed following a summary judgment application on the basis that the policy excluded coverage for vandalism if the property was vacant. The issues left to be decided by the Court were whether Meadow North had breached a duty owed to the plaintiff as his broker, whether the breach was a proximate cause of the loss, and whether the plaintiff had breached his duty to advise of a material change in the risk thus voiding the policy.

In 1993 the plaintiff attended at Meadow North’s office and completed an application for insurance for the property. The policy was issued and renewed annually thereafter. A booklet that outlined the policy stated that coverage for vandalism while the property was vacant was excluded.  It also stated that the plaintiff was required to notify the insurer within 30 days if the property became vacant. The insured was operating under the assumption that during those 30 days he would be coved for vandalism. That was not the case, as his coverage ended immediately upon vacancy.

In 2004, the property sustained $30,000.00 in damage shortly after the plaintiff’s tenants had vacated the property. The plaintiff asserted that he was not aware of vacancy exclusion.

The Court found that Meadow North breached the duty of care owed to the plaintiff and that it was a proximate cause of the loss. There was no evidence that the plaintiff was provided with the booklet that outlined the coverage and the exclusions, nor was he advised about the fact that coverage would not be provided immediately when the property became vacant. It was reasonably foreseeable that a policy holder may think that they had 30 days to advise of the vacancy. Meadow North had a stringent duty as an insurance broker to provide information and advice to the plaintiff about his insurance coverage, including any gaps it may have had.

The plaintiff was awarded $30,000.00 in damages, plus pre-judgment interest, and costs.

This case was digested by Kim Yee and edited by David W. Pilley of Harper Grey LLP.

Limitation period in policy trumps Limitation Act

Appeal by the insured from the dismissal of his action on the basis that the action was brought outside the one-year limitation period in the Insurance Act. The British Columbia Court of Appeal held that the trial judge erred in law in failing to apply the two-year limitation period contained in the policy and further that the policy limitation gave rise to a rolling limitation period.

Sander v. Sun Life Assurance Co. of Canada, [2011] B.C.J. No. 5, January 6, 2011, British Columbia Court of Appeal, L.S.G. Finch C.J.B.C., M.E. Saunders and K.E. Neilson JJ.A.

The appellant insured, a former dentist, received disability benefits from the respondent insurer under a group insurance policy after being diagnosed with cataracts. The insurer advised the insured in June 2001 that no further benefits would be made because the insured had refused to undergo cataract surgery as was required under the policy. The insurer provided the insured with a notice of denial by letter dated June 29, 2001. The insured underwent cataract surgery in 2003 but maintained that he was still unable to practice dentistry. He then commenced an action for disability benefits.

At issue was whether the insured’s action was barred for being commenced outside the limitation period. At summary trial, the Supreme Court of British Columbia held that the action commenced by the insured was barred by s.22(1) of the Insurance Act, R.S.B.C. 1996, c. 266 (the “Act”) which mandates that, “…every action on a contract [of insurance] must be commenced within one year after the furnishing of a reasonably sufficient proof of loss or claim under the contract…”. The summary trial judge held that the one-year limitation period was triggered when the respondent insurer provided the insured with a notice of denial by letter dated June 29, 2001. The limitation period for issuing a Writ of Summons therefore expired and the Writ of Summons was issued out of time.

The insurance policy held by the insured stated that:

“No action or proceeding against the Company for recovery of a claim under this policy shall be commenced more than two years after the date the insurance money became payable or would have become payable if it had been a valid claim.”

The Court held that the limitation period in Part 2 of the Act guarantees a minimum level of protection. However, the Court held further that the insurer must be held to the terms of the contract it provided where they are more favourable to its insured than the provisions of the Act. The Court held that insurers are only prohibited from providing a less generous limitation period than that which is prescribed in Part 2. The Court held that nothing in s.3(a) prevents an insurer from stipulating for a limitation period greater than in the Act itself. As such, the Court held that the two-year limitation period as set out in the insurance policy prevailed over that set out in the Act.

The insured argued further that the wording in the policy limitation has been interpreted in cases involving continuous entitlement to benefits as creating a “rolling” limitation period where that cause of action accrues at each successive interval at which benefit instalments are to be paid. In other words, so long as the insured continues to be entitled to benefit payments as a result of a continuous disability, the cause of action against the insurer is renewed every time a benefit becomes payable.

The Court held that upon review of the insurance policy, it was clear that the insured had a right to monthly benefit payments so long as he met the conditions of the insurance policy with regard to total disability. The risk insured against was continuing total disability and in that sense, insurance money was also payable on a continuing basis after the prescribed elimination period. As such, the Court concluded that each benefit payment gave rise to its own limitation period and the insured had a continuing claim through the period of disability. That claim was not extinguished by the failure to sue within two years of the commencement of that continuum. The insured’s claim accrued monthly and therefore the limitation must be viewed as commencing a new on each successive entitlement.

The appeal was allowed and the order of the summary trial judge set aside. The action was remitted to trial for determination of whether the insured was entitled to benefits under the insurance policy for the period of two years preceding the date on which he issued the Writ of Summons and anytime thereafter.

This case was digested by Aaron D. Atkinson and edited by David W. Pilley of Harper Grey LLP. If you would like to discuss this case further, please feel free to contact them directly at aatkinson@harpergrey.com or dpilley@harpergrey.com or review their biographies at http://www.harpergrey.com