Tomec v Economical Mutual Insurance Company – Limitation Period To Dispute A Denied Benefit Is Not Subject To Discoverability Mr Michael J. Henry and Daniel Fisher

Recently, the Divisional Court released their decision in Tomec v Economical Mutual Insurance Company, 2018 ONSC 5664. This Appeal concerned the issue of whether the limitation period set out in the Insurance Act and the SABS is a "hard" limitation period, such that the limitation period begins two years from the date of denial of a benefit, or a "soft" limitation period, such that the limitation period only begins to run when the insuredʼs right to claim the benefit is discovered.

In Tomec, the insured submitted an Application for approval of an assessment for a file review to evaluate the issue of Catastrophic Impairment (CAT). On August 26, 2010, the insurer responded. In the insurer's response, the following was noted:

In accordance with Section 18(2) of the Statutory Accident Benefits Schedule, no attendant care benefit is payable for expenses incurred more than 104 weeks after the accident unless you have been determined to have sustained a Catastrophic Impairment as defined by the Statutory Accident Benefits Schedule.

In accordance with Section 22(3) of the Statutory Accident Benefits Schedule, no payment for housekeeping and home maintenance benefits are payable for expenses incurred more than...