Actuarial Notes

Landmark Legal Insurance Cases in Canada

By Casualty Actuarial Society · 2026

Study guide: Exam 6C

A compilation of Canadian insurance-law decisions that the CAS supplies under this title in its Exam 6C study kit. The content outline lists the fifteen items it covers — court decisions and a Privacy Commissioner's report of findings — and adds two later Ontario Court of Appeal decisions that are not in the kit, each assigned through a law firm's article about it.

On the syllabus

  • Exam 6C — objective A2; the compilation, in the study kit, covering the cases below, with Morrow v. Zhang limited to Sections I, II, III, IV, VI (E), VII, VIII and IX; Tomec v. Economical and Loblaws v. RSA are not in the study kit and are assigned through online articles on them.

Whiten v. Pilot Insurance Co.

  • 2002 SCC 18, [2002] 1 S.C.R. 595.
  • The Supreme Court restored a jury's award of $1 million in punitive damages against an insurer that contested a fire claim in bad faith on an arson allegation (LeBel J. dissenting on the appeal).
  • Besides its obligation to pay the claim, the insurer was under a distinct and separate obligation to deal with its policyholders in good faith; breach of that duty of good faith is an independent actionable wrong that can support punitive damages in a contract case (Bad Faith Damages).

Somersall v. Friedman

  • 2002 SCC 59, [2002] 3 S.C.R. 109; an appeal by the insureds' automobile insurer, Scottish & York, from the Court of Appeal for Ontario.
  • A limits agreement in which the insureds promised the underinsured tortfeasor not to pursue him beyond his policy limits, made without notice to their insurer, did not bar their claim under the SEF 44 Family Protection Endorsement: legal entitlement to recover is determined at the time of the accident (Major and Binnie JJ. dissenting).
  • The insurer's right of subrogation had not arisen, since it had made no payment and the insureds had not been fully indemnified (subrogation).

Somersall v. Scottish and York

Sansalone v. Wawanesa Mutual Insurance Co.

  • 2000 SCC 25, [2000] 1 S.C.R. 627.
  • A bus driver sued for sexual assault, on claims pleaded as battery, negligent battery, negligent misrepresentation and breach of fiduciary duty, was owed no defence under his homeowner's policy: for the reasons in Scalera, the claims could not trigger coverage under a policy excluding bodily injury caused intentionally, and the duty to defend applies only to potentially indemnifiable claims.
  • An explicit exclusion for sexual molestation in an optional day care endorsement does not imply that sexual torts are covered in every other context.

Nichols v. American Home Assurance Co.

  • [1990] 1 S.C.R. 801.
  • The duty to defend, while broader than the duty to indemnify, arises only where the pleadings raise claims that would be payable under the policy's agreement to indemnify; the mere possibility that a claim within the policy may succeed is enough.
  • Because the only damages claimed against the insured were for fraudulent acts, which the policy did not cover, the insurer had no duty to defend.

Amos v. Insurance Corporation of British Columbia

  • [1995] 3 S.C.R. 405.
  • Whether injuries arise out of the ownership, use or operation of a vehicle, for no-fault benefits, is a two-part test: did the accident result from the ordinary and well-known activities to which automobiles are put, and is the relationship between the injuries and the vehicle causal — not necessarily direct or proximate — rather than merely incidental or fortuitous.
  • The insured, shot by assailants trying to get into his van, was covered: the shooting arose out of his ownership, use and operation of the vehicle.

Alie v. Bertrand & Frere Construction Company Limited

  • Court of Appeal for Ontario, 6 December 2002.
  • The CGL policies, it was common ground, are not performance bonds for the insured's own defective work or product; the court upheld the finding that the damage to the homes went beyond the concrete supplied and was property damage resulting from an occurrence within all the policies.
  • Coverage is triggered when damage is suffered within the policy period ("injury in fact"); where the damage in each period could not be determined, a continuous trigger let the trial judge apportion it pro rata across the affected policy periods.

Resurfice Corp. v. Hanke

Morrow v. Zhang

  • 2009 ABCA 215, (2009) 454 A.R. 221 — Court of Appeal of Alberta, 12 June 2009.

PIPEDA Report of Findings #2012-005

  • The Privacy Commissioner of Canada's findings on a complaint that an Ontario insurer used the complainants' credit information to calculate their property insurance premium (Credit-Based Insurance Scoring).
  • The purpose of collecting and using the credit information was found appropriate and that part of the complaint not well-founded; but meaningful consent had not been obtained and the insurer was not open about its use of credit scores, which was well-founded and conditionally resolved on the insurer's commitments to amend its consent clause, notify policyholders and explain the practice on its website.

Kusnierz v. Economical Mutual Insurance Company

  • 2011 ONCA 823.
  • Physical and mental or behavioural impairments may be combined in assessing whole-person impairment under clause 2(1.1)(f) of the Statutory Accident Benefits Schedule, and the appellant met the definition of catastrophic impairment, entitling him to enhanced medical and rehabilitation benefits.

Aviva Canada Inc. v. Pastore

  • Pastore v. Aviva Canada Inc., 2012 ONCA 642.
  • It was reasonable to decide that a class 4 (marked) impairment due to mental or behavioural disorder under clause 2(1.1)(g) of the Statutory Accident Benefits Schedule means a marked impairment in a single area of function, and to include pain from physical sources connected with the diagnosed mental disorder; the director's delegate's decision upholding the finding of catastrophic impairment was reinstated.

Belanger v. Sudbury

  • Belanger v. Sudbury (Regional Municipality), 2017 ONCA 428.
  • The court dismissed the Region's appeal from a judgment holding it 100 per cent liable for a collision on a snow-covered, slippery regional road that was in a state of non-repair, upholding the rejection of its statutory defences (no knowledge; reasonable steps) and of contributory negligence.
  • Proof of a state of non-repair is not in itself sufficient to establish a municipality's liability for road maintenance.

Precision Plating Ltd. v. Axa Pacific Insurance Co.

  • 2015 BCCA 277 — Court of Appeal for British Columbia, 18 June 2015.

Saadati v. Moorhead

Tomec v. Economical

  • Tomec v. Economical Mutual Insurance Company, 2019 ONCA 882; assigned through S. O'Connor and S. Reich, "Two-Year Limitation Period to Dispute Denial of Accident Benefits is Subject to Discoverability" (Kelly Santini LLP, 2019).
  • The two-year limitation periods in s. 281.1(1) of the Insurance Act and s. 51(1) of the Statutory Accident Benefits Schedule for disputing a denial of benefits are subject to the rule of discoverability rather than being hard deadlines, and the court declared that the limitation period for the appellant's attendant care and housekeeping benefits had not expired.

Loblaws v. RSA

  • Loblaw Companies Limited v. Royal & Sun Alliance Insurance Company of Canada, 2024 ONCA 145; assigned through Mark J. Robertson, "No More than What they Bargained For: Ontario Court of Appeal rejects All Sums Approach to Defence Costs" (Cox & Palmer, 2024).
  • Insureds facing opioid class actions spanning several consecutive primary liability policies could not choose one policy and require that insurer to defend all the claims ("all sums"); defence costs are shared pro rata by each insurer's time on risk (Duty to Defend).
  • Each policy's self-insured retention or deductible must be exhausted before its duty to defend is triggered, and there is no recovery of defence costs incurred before notice to the insurers.

Related readings

  • Baer and Rendall — also assigned for objective A2
  • McDonald — also assigned for objective A2
  • Davidson — also assigned for objective A2
  • IBC Code of Conduct — the Code that the PIPEDA report of findings reviewed

Sources