Bayda Disability Law Firm

Disability Insurance company is entitled to deduct overpayment POSTED ON JUNE 12, 2014 BY ALLANBAYDA In the case of Garneau v. Industrial Alliance Insurance and Financial Services Inc., 2014 ONSC 1495 (CanLII) the Ontario Supreme Court found that Industrial Alliance was entitled to the self help remedy of deducting 3 months benefits and 50% of future benefits to recapture an overpayment made by Industrial Alliance. The court stated: [37] In Ruffolo and Lepage v. Su...n Life Assurance Co. of Canada [2007] 64 C.C.P.B. 277, at para. 7, Perell J. held that an insurer who discovers that it has overpaid an insured is entitled to the self-help remedy of withholding the future LTD payments until it has repaid itself. He held that the offsetting of benefits by a LTD insurer to recover an overpayment was not unreasonable, unconscionable, unexpected, illegal, or contrary to public policy. In Ruffolo the Court also held that Sun Life was not entitled to charge interest on the overpayment of benefits. [38] In this case, Industrial has not charged Ms. Garneau any interest on the $114,446.76 overpayment which is being repaid by deducting 50 percent of her ongoing monthly LTD benefits. Following the reasoning of Ruffolo above, I find that Industrial was entitled to exercise the remedy of self-help and was entitled to deduct 50 percent of Ms. Garneau’s LTD benefits to repay the overpayment. I further find that when Industrial exercised the self-help remedy of reducing Ms. Garneau’s LTD benefit by 50 percent ($9,636 per year), which amounted to approximately a 19.61 percent reduction of her total income, it did not breach Industrial’s duty of good faith or fair dealing to Ms. Garneau. [39] I further find that a trial is not required to make a fair and just determination on merits that Industrial’s exercise of the self-help remedy of reducing 50 percent of Ms. Garneau’s LTD benefits does not constitute an unfair action or a breach of Industrial’s duty of utmost good faith. The facts are not in dispute and no credibility findings must be made to decide this issue.

Testimonial from Connie B in Edmonton - Mr. Allan Bayda was there for me after one phone call. My 8 years battle with C.R.P.S. has been a long road. My pain extreme and my mind could not process the strength it required to process day to day life. I needed help and reached out to Bayda Disability Law Firm. http://baydadisabilitylaw.ca/testimonials/

Totally disabled means different things in different insurance policies. It does not necessarily mean unable to do anything. It does not mean being completely helpless and in a vegetative state. The courts use a more pragmatic real world approach. They look at what is reasonable in the circumstances including level of education obtained, training, prior work experience, prior salary, etc. http://www.disabilitylaw.ca/Legal_Principles.html