What decisions have been considered in determining whether a policy is an income continuation benefit plan?

Ontario, Canada


The following excerpt is from 17-000751 v Economical Mutual Insurance Company, 2018 CanLII 81896 (ON LAT):

The Respondent submitted the decisions of Stojanov v. Dominion of Canada General Insurance Company[4] and Bhola v. Personal Insurance Company of Canada[5]. These decisions note in determining whether a policy is an “income continuation benefit plan” requires a detailed consideration of the policy. Relevant factors to consider in reviewing the policy include: 1. Whether the benefits are linked to being actively and regularly working at the onset of disability; 2. Whether the disability test is inability to perform pre-disability employment duties; 3. Whether post-disability earnings are deductible; 4. Whether the disability insurer has subrogation rights directly tied to the claimant’s income; 5. Whether the employer is involved in arranging for and paying for the disability policy, and; 6. Whether the benefits cease when the claimant is no longer disabled from working or at an age reflecting retirement.

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