Long-Term Disability Insurance Lawsuit

Long-Term Disability Lawsuit:

Expert insights from long-term disability lawyer Tim Louis.

Many of my long-term disability clients are under the mistaken belief that if they win at trial the judge will order the insurance company to pay my client one lump sum equivalent to the amount of each monthly payment multiplied by the number of months from the trial to the date of my client’s retirement. Unfortunately, this is not the case. If you win your long-term disability lawsuit the court will order your insurance company to begin paying you monthly. There will be no lump sum representing what is referred to as “future benefits”.

With the above in mind, I was quite interested in the Court of Appeal decision in a case approximately three years ago. The Plaintiff, Nadine Lydia Gascoigne, had successfully sued Desjardins Financial Security Life Assurance Company for her long-term disability benefits. Her lawyer had asked the trial judge to aware a lump sum for Ms. Gascoigne’s future benefits. The trial judge refused to do so and instead ordered Desjardins to begin making monthly payments. Her lawyer appealed the trial judge’s decision not to award a lump sum for future benefits.

The BC Court of Appeal turned down Ms. Gascoigne’s appeal. Here are two paragraphs from the BC Court of Appeal Decision:

[29] In short, in my view, the trial judge correctly found he was bound by Warrington, as we are, to find that a non-contracting beneficiary of a group policy is entitled to enforce the payment of benefits, but not entitled to terminate the group policy or accept the insurer’s repudiation.

[30] The appellant did not advance any basis other than fundamental breach of the policy as a ground upon which she might be entitled to a lump sum award. It is not necessary, therefore, for us to determine whether such an award can be made for the breach of a disability insurance contract and breach of the duty of good faith. However, in this case, two obstacles stood in the way of such an award. First, the bad faith established was not found to be such as to preclude continuing performance of the parties’ contractual obligations, and second, the appellant’s own expert witness testified that she has “not yet reached the point of maximal medical improvement”. Some further interventions were contemplated, and she would suffer “some degree of vocational disability” for “an unknown period of time”. There was clearly a basis for the judge to say the evidence did not establish that the appellant would remain disabled from any occupation. He could properly regard that as a reason not to grant any relief other than the declaratory order made with respect to continuing benefits.

This means that the law remains as it always has been – if you successfully sue your long-term disability company, you will not be awarded a lump sum for future benefits, but rather begin receiving monthly payments.

Read more about the long-term disability lawsuit case here:

Gascoigne v. Desjardins Financial Security Life Assurance Co. (c.o.b. Desjardins Insurance), [2020] B.C.J. No. 1821, 2020 BCCA 316, British Columbia Court of Appeal, November 3, 2020, M.E. Saunders, P.M. Willcock and G.B. Butler JJ.A.

 

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