Kaur v. Medavie Blue Cross, 2017 ONSC 7396 (CanLII)
Blue Cross. (the insurer) motions for a partial summary judgement in the case Kaur v. Blue Cross, wherein they request that if Kaur (the insured) receives Long Term Disability benefits that they be able to deduct the Income Replacement Benefits (IRB) that she received.
Kaur was involved in a motor vehicle accident on November 29th, 2010. She claimed IRB and receive $6,915.85 from Certas Direct Insurance Company. Certas terminated her benefits on May 20, 2011. Kaur commenced legal proceedings and received a lump sum of $40,000 in addition to the sums that were already paid to her.
Kaur also applied for LTD benefits from Blue Cross through a policy she had with her place of employment. Her claim was denied on April 8, 2011. If her claim had been accepted, she would not have been eligible to receive benefits until April 5, 2011 based on Blue Cross’ elimination period.
Kaur commenced an action against Blue Cross, and a separate action against Blue Cross Life Insurance as well as tort against the other driver.
- Blue Cross wants to deduct the amount of IRB that Kaur received from any funds they are obligated to pay her.
Kaur commenced an action against Blue Cross for the wrongful denial of her benefits. Blue Cross then asked to court to deduct the amount of the IRB funds that Kaur received from any long-term disability benefits, if any, Kaur would be entitled to. Finding the information provided to be insufficient, the Judge dismissed the motion.
A disabled individual must strive to protect all areas of funds they may receive from an insurance company.
Should you find yourself in a similar position to Kaur wherein your benefits company is denying your claim, contact a disability insurance lawyer to assist you in recovering money you rightfully deserve.