The Dominion of Canada v. Chambers 2013 ONSC 6122

The applicant was involved in three motor vehicle accidents: May 18, 2003, June 20, 2003, and February 3, 2005. All three accident benefit claims were presented to Dominion.

In April, 2012, the applicant submitted an Application for Determination of Catastrophic Impairment to Dominion, claiming that they sustained a catastrophic impairment as the result of the cumulative injuries from all three accidents. Dominion refused to accept the OCF 19 on the basis that it had to be submitted for each accident, or for the accident that resulted in the catastrophic impairment claimed. In a subsequent court action, Dominion brought an application to determine the issue.

While Dominion did agree that several accidents may contribute to an applicant’s condition, it argued that the language of the legislation is “singular”, in that it refers to an accident, rather than multiple accidents. Dominion also argued that to permit an Applicant to claim a catastrophic impairment arising from numerous accidents would allow access to increased policy limits on a variety of benefits, a result that was never intended by the drafters of the legislation.

Dominion provided numerous examples of the Statutory Accident Benefits Schedule – Effective September 1, 2010 where the language points to a singular meaning of “accident”. As well, the OCF 19 form itself, which is mandated by section 66 of theSABS, requires a physician to fill out the date of “the accident”. Dominion relied upon established principles of statutory interpretation, and definitions of the words “an” and “any” found in Blacks Law Dictionary. Dominion also provided evidence for the proposition that the SABS is focused on providing benefits to an insured person as a “result of a single car accident”:

  • the references in the SABS are in the singular;
  • policy limits for SABS are in respect of one accident;
  • the time period to determine entitlement to SABS is in respect of an accident and the test for entitlement involves a consideration of an insured’s activities before the accident;

The Plaintiff asserted the proposition, set out in Monks v. ING Insurance Company of Canada, 2008, ONCA 269, that “insurance coverage provisions are to be interpreted broadly, while coverage exclusions or restrictions are to be construed narrowly, in favour of the insured”. Additionally, she provided examples of instances within theSABS where contemplation of other accidents is made. Further, the SABS makes use of the words “an” and “the” almost interchangeably.

In deciding the issue, Madam Justice Rady referred to the accepted practice of utilizing the “ordinary meaning rule” as the starting point of statutory interpretation. The following three principles are set out in her decision:

  1. It is presumed that the ordinary meaning of a legislative text is the meaning intended by the legislature. In the absence of a reason to reject it, the ordinary meaning prevails.
  2. Even if the ordinary meaning is plain, Courts must consider the purpose and scheme of the legislation, and relevant legal norms. They must consider the entire context.
  3. In light of these considerations, the Court may adopt an interpretation that modifies or departs from the ordinary meaning, provided the interpretation adopted is plausible and the reasons for adopting it are sufficient to justify the departure from ordinary meaning.

Justice Rady uses the terminology set out in section 3 of the SABS as verification that the intention of the legislature to refer to a single accident. The terminology includes numerous references to “the accident”. However, it should be noted that there are references to “an accident” numerous times within that section.

Justice Rady determined that the use of the words “the accident” supports “the common sense interpretation that the references to an accident and the accident mean a single accident”. As well, she found support for this conclusion within the wording of the OCF 19, which requires the applicant to cite the date of “the accident”, and also contains a Note to Applicant provision that includes wording that supports the singular interpretation.

Finally, Justice Rady confirmed that on the evidence before her, the first and second accidents were not of a sufficient nature to render the applicant catastrophically impaired. It was only after the third accident, what Justice Rady refers to as the “tipping point” and the “catalyst”, that the applicants’ impairments were increased to a level that could possibly qualify for a catastrophic determination. Importantly, Justice Rady found that the injuries sustained in the earlier accidents “should not effectively render each accident liable to a retroactive catastrophic impairment determination”.

This decision would thus preclude an applicant from claiming “stacked” limits on benefits from successive accidents. It would also prevent an applicant who settled a claim from a previous accident from going back to that insurer and seeking increased benefits on the basis of a CAT determination on a successive accident. However, it will also permit an applicant to rely on injuries sustained in a prior accident as being contributory to the catastrophic level of impairment arising from the accident which is the proper subject of the submitted OCF 19. In effect, this decision ensures finality with respect to settlements, and that insurers are properly reserved for potential losses.