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The decision in Symons v. Insurance Corporation of British Columbia, 2016 BCCA – Summary and Implications

August 17, 2016

Facts

 

The plaintiff was seriously injured in a motor vehicle accident when she was rear-ended by a truck on April 20, 2008. She was disabled from working for two weeks and received disability benefits from ICBC. On May 2, 2008, she returned to work and her benefits were discontinued. Over the next several years her injuries worsened and she again became disabled from work. On January 23, 2013, over four and a half years after the accident, the plaintiff asked ICBC to reinstate her disability benefits. ICBC did not approve her request, saying the applicable legislation only permitted continued disability payments to those disabled “at” the 104-week mark of the accident.  The plaintiff sued ICBC for reinstatement.

 

Chambers decision

 

The chambers judge awarded the plaintiff reinstatement of her disability benefits. He concluded that under section 86 of the Insurance (Vehicle) Regulations (“Regulations”), insured persons who received disability benefits but recovered before the 104 week mark of the accident were entitled to reinstatement of those benefits if they again became disabled after the 104 week mark. The fact they were not disabled “at” the 104 week mark was not a bar to reinstatement.

 

Issue

 

The issue on appeal was whether the chambers judge correctly interpreted the disability benefits provisions in section 86 of the Regulations.  

 

Appeal Decision

 

Under section 80 of the Regulations, certain insured people becoming totally disabled from work within 20 days of their motor vehicle accident are entitled to disability benefits for a maximum of 104 weeks. Section 86 provides that if their injuries continue disabling them “at the end of the 104 week period” they are entitled to continued disability benefits to a maximum of their attaining the age of 65.

 

In this case ICBC took the position that the language of section 86 provides that to continue receiving benefits after 104 weeks, the insured must be disabled and receiving benefits “at the end” of the 104 week period. Therefore, insureds like the plaintiff whose initial disability resolves but arises again after the 104 week period do not qualify for continued benefits.  

 

Our Court of Appeal upheld the plaintiff’s benefits award and dismissed ICBC’s interpretation of section 86 if the Regulations, holding there was no “magic” to the 104 week mark. They reiterated the well settled principle that ICBC’s benefits-conferring legislation should be interpreted in a broad and generous manner in light of its objectives of providing access to compensation for those who suffer losses in motor vehicle accidents. In this context, our Court of Appeal confirmed that failing to be disabled at the 104 week mark of the accident is no bar reinstatement of disability benefits under section 86 of the Regulations:

 

“Reading the words of this legislative scheme in its entire context, harmoniously with the whole of the scheme and purpose, leads to the conclusion that if a person who was         disabled as a result of an accident returns to work, and then, because of setbacks or   otherwise, is again totally disabled due to the accident, she qualifies for benefits under s. 86, even if she was not disabled on the “magic” day at the end of 104 weeks. This interpretation is consistent with the object of the Act – to provide no-fault benefits for persons injured in motor vehicle accidents” (paragraph 24).

 

Take Away

 

This case settles law in B.C. on whether entitlement to continued disability benefits under section 86 of the Regulations requires disability “at” the 104 week mark. ICBC can no longer use non-disability at the 104 week mark to deny reinstatement of disability benefits to those whose disability returned after that period.  ICBC will want to be mindful of this newly confirmed potential exposure to disability claims by recovered insured’s whose disabilities return after the 104 week mark.

 

This case is also an example of our courts willingness to go beyond the plain language of ICBC’s benefits legislation to achieve the legislation’s objectives. The plain language of the legislation states that continued disability “at the end” of the 104 week period is required to qualify for section 86 disability benefits. Rather than leaving it to the provincial government to address, the court has created exceptions for insured’s who recover before the 104 week period and return to disability thereafter. Those individuals are no longer required to be disabled “at the end” of the 104 week period to qualify for section 86 benefits. This is a reminder to ICBC that courts are willing to take a broad and generous interpretation of benefits-conferring statutes.  It may also serve as a reminder to legislative and executive branches of government that, with respect to benefits-conferring legislation, strong language is required to express an intent that appears contrary to the legislation’s objectives.

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