Should you consider buying supplemental health coverage?

TARA DESCHAMPS

The Canadian Press

When Canadians seek medical attention for broken bones or emergency appendectomies, the country’s health care system allows most to head to the hospital and be looked after without the burden of a big bill.

But filling a prescription, seeing an optometrist or going to the dentist for a checkup all come with a price tag passed along to patients. While many have health insurance through employers, spouses or schools, plenty of people lack such a luxury because they are unemployed, self-employed or simply working for a company that doesn’t offer such benefits.

Jessica Moorhouse, a 33-year-old personal-finance blogger, says those without additional health care coverage should educate themselves on what is and what isn’t provided by the government to identify gaps they might need to cover.

Then, work out what kind of health expenses you typically have and calculate how much it would cost to pay cash versus paying an insurance provider for that extra health care, Moorhouse says.

People who require pricey prescriptions or a high level of medical attention not covered by the government might find signing up for a health care plan is a better value than paying out of pocket, but the opposite might be true for people who have few medical needs.

“The past few years it’s made more sense for me to just save and pay cash, but in the future as I get older or start a family, my position and needs may change,” Moorhouse says.

“Health coverage beyond what’s included in Canada’s medical system may not be necessary for everyone, so you really need to look at your situation right now and also consider what you may require in the future in terms of health care.”

If you decide that a plan is right for you, Moorhouse recommends putting aside plenty of time for research. Alternatively, you could go via a broker who will find you the best price and policy.

If you’re a university or college student, most schools will offer plans at discounted rates. Some will auto-enrol every student in the plan, but if you already have coverage, you can apply to opt-out of it and receive your money back.

When seeking quotes, Moorhouse recommends people take a peek at some of the online calculators run by health insurance companies that will provide a free quote. Sun Life Financial and Blue Cross Canada are among the dozens of businesses offering such estimates.

“In the past when I’ve asked for quotes I’ve heard $100 to $150 per month just for a basic dental and vision plan is the norm, but again, it really depends on a number of variables,” says Moorhouse.

Keep an eye on restrictions and percentages of coverage too, she says.

“Just because you’re on an insurance plan does not mean you will be covered 100 per cent for that dentist visit,” she explains. “Usually you’ll be paying your insurance premiums plus 40 to 50 per cent of the cost of going to the dentist.”

Moorhouse says if you decide to forgo a plan, put aside some money for health care expenses instead.

According to her, the best way to figure out how much to save is to calculate the costs of the services you’ll need.

“Everyone’s needs are different,” says Moorhouse. “For myself, my needs are dental cleanings twice per year and an eye exam and possibly new glasses every two years…. I don’t need any prescriptions and I don’t have any health issues.”

Once you determine what it will cost for the services you need, you should put that money in a savings account along with some extra cash for unexpected charges or changes in prices, says Moorhouse.

You should be putting automatic contributions into the savings account so it becomes part of your regular budget and so you’re never left with an empty fund, she says.

BC Court of Appeal Upholds Special Costs Award Against Disability Insurer Despite No Litigation Misconduct

Reasons for judgment were published today by the BC Court of Appeal finding that trial judges do have authority to award special costs against litigants even in circumstances where no litigation misconduct occurred.

In today’s case (Tanious v. The Empire Life Insurance Company) the Plaintiff was insured with the Defendant.  She became disabled and sought long term disability benefits but the Defendant ‘rejected her claim’.  The Plaintiff successfully sued and was awarded damages along with an order of special costs.

The Defendant appealed arguing the judge was wrong in awarding special costs absent litigation misconduct.  The BC Court of Appeal disagreed and found that in “exceptional cases” such awards could be justified.  In upholding the award the court provided the following reasons:

[69]         To summarize, in British Columbia the general rule is that party and party costs are awarded to a successful litigant in the absence of litigation misconduct.  In ordinary litigation, this partial indemnity strikes a fair and proper balance of the costs burden to be borne by the winning and losing parties and enhances the policy objectives of predictability and consistency.  However, in exceptional cases special costs may be awarded for non-punitive purposes in the interests of justice to provide a higher degree of indemnification to the successful party.  When deciding whether to award special costs, a judge should exercise his or her discretion based on established principles and consider the nature and conduct of the litigation, bearing in mind the purposes and objectives of the costs regime, any salient policy considerations and the relevant facts as established by the evidence…

[77]         I am not persuaded that the judge erred in law or principle in exercising his discretion to award special costs in the circumstances of this case.  Nor, in my view, is the award so clearly wrong as to amount to an injustice.  The judge concluded that disability insurance claims are a uniquely challenging, complex and costly type of contractual dispute litigation and that Ms. Tanious experienced the challenges, complexities and costs inherent in such claims to an extent that special costs were warranted in the interests of justice.  There was an evidentiary basis for his conclusion, which, in my view, was not unreasonable.  Bearing in mind the privileged position he occupied and the high degree of appellate deference that applies, I would not interfere with the judge’s principled determination.  

[78]         I do not accept Empire Life’s submission that the judge compensated Ms. Tanious twice for the emotional harm its conduct caused by making both an award for mental distress damages and a special costs award.  The special costs award responded to the impact of the unique characteristics of the disability insurance contract in the litigation, not the emotional consequences of its breach.  Nor do I accept Empire Life’s submission that the judge erred by holding, in substance, that a disability insurance policy confers a contractual right to full indemnity costs.  On the contrary, he repeatedly stated that it did not. 

[79]         I am satisfied that, despite some ambiguity, when the reasons are read as a whole it is reasonably apparent that the judge exercised his discretion to award special costs based on his assessment of the interests of justice in all the circumstances of the case, not based on a contractual obligation.  His references to “contractual obligations” and the need to realize the “full benefit of the contract” must be read within the context of the entire decision. Had the judge relied on a contractual analysis in making the special costs award, I would agree with Empire Life that he erred in principle.  However, it seems to me that the “driving consideration” for the judge was the injustice he saw in permitting the unique challenges, complexities and costs inherent in disability insurance litigation to render an impoverished and disabled litigant’s pursuit of subsistence-level insurance benefits wholly impractical. 

[80]         In other words, while he did not express it in precisely these terms, at bottom, the judge’s concern with fulfilling the “intention of the insurance coverage” was the need he perceived to provide meaningful access to justice to Ms. Tanious in the unusual circumstances in which she found herself.  Importantly, that need arose in the context of a unique and distinct category of contractual dispute litigation, namely, a claim for subsistence-level disability insurance benefits, and not in the context of an “ordinary” insurance or personal harm claim.

[81]         As I have noted, the Supreme Court of Canada recently emphasized the importance of ensuring access to justice as a policy objective.  Long embedded within the law of costs, our understanding of the consequences of failing to achieve this objective has grown significantly in the last two decades, as the Report highlights.  In seeking to achieve justice in this case, the judge considered the merits of the case, weighed the consequences of a special costs award for both parties and decided it would be contrary to the interests of justice to ask Ms. Tanious (or her “low bono” counsel, Ms. Hayman) to bear the financial burden associated with pursuit of her claim: see Carter.  I see no error in his overall approach, which, in my view, was based on principle, not sympathy, and, given its narrow parameters, did not amount to judicial overreach.

[82]         As discussed, where reasons of principle and policy do not apply the law may evolve without resiling from a general rule by recognising policy-based exceptions: see Fidler; Hollander.  In my view, the law of costs has evolved to the point that a judge may consider a litigant’s challenging personal and financial circumstances, including the availability and nature of counsel’s services, in a disability insurance claim of this sort where there is an evidentiary basis for doing so and, if the interests of justice warrant it, may depart from ordinary costs rules and award special costs in the absence of reprehensible conduct.  The factors in question are linked to the exceptional nature of such a claim and, therefore, the usual costs principle favouring partial indemnity in ordinary litigation may not be applicable.  On the other hand, consideration of these factors in such cases enhances the policy objective of ensuring access to justice for disadvantaged litigants by, for example, encouraging more lawyers to act on deserving but otherwise unremunerative disability insurance claims.

[83]         Moreover, in my view, the policy objectives of predictability and consistency are not compromised by this incremental development in the law of costs, at least not significantly.  Given the unique nature of the particular contractual relationship in question and the related dispute, unlike many opposing litigants, disability insurers are likely to be familiar with an insured’s circumstances and the associated implications of denying benefits and to consider them when assessing their costs exposure.  Further, the prospect of facing a special costs award if a denial of benefits turns out to be unjustified may well encourage disability insurers to scrutinize claims extremely carefully at every stage of litigation, which, in turn, may encourage settlement and avoid the sort of cursory response seen here that falls short of bad faith but negatively impacts access to justice for a disadvantaged litigant.  On the other hand, if, on close and continuous examination, a defence appears strong and meritorious, the possible price of losing seems unlikely to keep a well-resourced disability insurer from the courtroom door: see Sidorksky.

[84]         In the final analysis, in my view, in balancing the parties’ interests in this unique litigation the judge did not err by concluding that it was just for the unsuccessful institutional defendant to indemnify the impoverished and disabled claimant fully for the reasonable costs of pursuing her claim for subsistence-level disability insurance benefits and, therefore, awarding special costs.

bc injury law, LTD, special costs, Tanious v. The Empire Life Insurance Company

Southern Manitoba communities drenched, with some seeing more than 100 mm of precipitation

Read more

Province’s auto insurance plan deemed problematic by lawyers

Some of the Ontario government’s proposed changes to auto insurance laws will not reduce insurance costs and premiums, the Federation of Ontario Law Associations said.

In a Sept. 17 submission, FOLA said that both plaintiff personal injury lawyers and insurance defence lawyers had several concerns about the proposed policies.

“These lawyers are on the front lines of the justice system and see its triumphs and shortcomings every day,” FOLA’s report said. “To us, the Care, Not Cash model had no merit when it was first proposed, and it has no merit now.”

In a separate Sept. 16 submission, the Toronto Lawyers Association said it supported some aspects of the government’s plan — such as reinstating the $2 million benefit limit for catastrophic car crash injuries, allowing recipients to decide how to split the money between medical, rehab and attendant costs. But like FOLA, the government’s plan also raised concerns for the TLA, both on the plaintiff’s and defence side of the bar.

For instance, a proposal to let people lower their auto insurance premiums by reducing their coverage to $1 million is problematic, the TLA wrote.

“Auto insurance policies are difficult for consumers to understand,” the TLA said. “Consumers who opt for $1 million in coverage may be required to turn to Ontario’s already overburdened health care system and other social welfare systems . . . . or they may be forced to suffer without the treatment they need.”

Both FOLA and the TLA said the province will need to focus on insurance broker oversight, as well as extensive campaigns to raise consumer awareness of these issues.

FOLA’s response to the government’s consultation said it is not clear why the government would ban settling with an insurance company. While fraudsters do take advantage of cash settlements, the government’s proposal is a “sweeping” change that would only prevent a small amount of fraud, the TLA said.

Source: Law Times

READ MORE HERE: 

Home Insurance – Types of Coverage

Comprehensive

As the most inclusive home insurance policy, comprehensive covers both the building and its contents for all risks, except for those specifically excluded. Two types of risk that are not normally included in any home insurance policy are:

The insured perils included in comprehensive and other policies include coverage for aircraft or vehicle impact, fire, lightning, theft and window breakage.

If you live in a condo/strata or mobile home, you require customized insurance for your property type.

Basic or Named Perils

If you want to save money and carry the financial risk of some losses yourself, consider a basic or named perils policy. This policy covers only those perils that are specifically stated.

Broad

If a comprehensive policy costs more than you want to pay and a basic or named perils policy isn’t suitable, a mid-priced compromise is the broad insurance policy. This policy provides comprehensive coverage on the big-ticket items, such as the building, as well as named perils coverage on the contents.

No Frills

Some insurers offer basic or no frills coverage for properties that don’t meet normal insurance standards. If there are physical problems with your home that keep it from meeting the standards set by insurers, you may save money in the long run by correcting these problems to qualify for better coverage.

Personal Liability

Whether you own or rent your home, you can be held liable for bodily injury or property damage unintentionally caused to others. Your home insurance’s personal liability portion provides coverage if such an event occurs on your property or anywhere in the world.

For example, if a visitor slips on a snow-covered walkway on your property and is injured, you may be held legally responsible. If you’re found negligent, your personal liability coverage would cover the damages resulting from the injury up to the coverage limit. Liability coverage does not apply to injuries sustained by you or members of your household.

In addition to the home coverage types described above, insurers may use trademarked product names to describe home insurance packages.

Source: IBC

Cyber Insurance And D&O Liability

Last Updated: September 19 2019

Article by Deepshikha Dutt

Introduction

In the past decade, there have been several reports of cybersecurity attacks and data breaches to large corporations.1 In many cases, those affected by the breach want to hold the directors and officers accountable, as they feel the corporation failed to implement the proper security measures to prevent a breach from happening or did not effectively handle the aftermath of the breach. However, directors and officers generally enjoy limited personal liability subject to a few exceptions.2 Nevertheless, as more specific guidance emerges for directors and officers handling cybersecurity issues, the scope of this liability may widen.3 Thus, directors and officers should not take comfort in the substantial barriers that prevent them from being held liable for issues relating to the organization.4 In fact, despite these substantial barriers, shareholders continue to pursue derivative actions against directors and officers.

This article will discuss the scope of personal liability directors and officers face relating to cybersecurity breaches, and recent actions pursued against directors and officers in Canada and the US. Following the article, key takeaways will be provided.

Scope of liability

Cybersecurity poses a significant threat to directors and officers as cyber threats continue to emerge, and the rules and regulations that guide cybersecurity continue to evolve. Directors and officers may be held liable in the event of a cybersecurity attack if they are found to have breached their duty of care or have failed to comply with any disclosure requirements. Moreover, directors and officers can be personally liable where a company fails to comply with Canada’s Anti-Spam Legislation (CASL).5

Directors and officers have a duty to exercise reasonable care and diligence, both at common law6 and under corporate statutes.7 Failure to oversee the company’s cybersecurity measures adequately, before and after a breach occurs, could be considered a breach of this duty.8 Moreover, failure to comply with federal and provincial disclosure requirements after a breach could lead to liability for secondary market misrepresentation.9

Therefore, having an appropriate response or compliance plan, and effective security measures to protect the company against future cyber threats is essential. This will help support any claim by a director or officer that all requisite care and diligence was met, and all regulations were complied with.10

Lastly, directors and officers can be held personally liable and receive fines where the company has violated CASL. Penalties for non-compliance with CASL carries a maximum fine of CA$1 million for individuals and CA$10 million for organizations.11 Moreover, directors and officers can be vicariously liable for non-compliance of an organization even where the regulator, Canadian Radio-television and Telecommunications Commission (CRTC), does not pursue the organization. In fact, the CRTC has made a public statement that directors and officers cannot hide behind their company’s structure or online entities to avoid liability.

Derivative actions in Canada and the US

Currently, there have not been any attempts at a lawsuit against directors and officers in relation to cybersecurity in Canada.12 However, given the amount of derivatives actions commenced in the US, it is possible that it could give rise to such claims in Canada. The US has seen several derivative action suits against directors and officers relating to cybersecurity over the past few years.13 All but one have been unsuccessful, largely due to technical and procedural reasons. However, in January 2019, a derivative action lawsuit settled for US$29 million, compensating the plaintiffs significantly.14 This is the first time shareholders have been awarded monetary damages for a breach-related derivative lawsuit. This settlement could spark the beginning of successful derivative action lawsuits, and inspire others to pursue civil actions against directors and officers for cybersecurity breaches. Moreover, this settlement can be used as a benchmark for future civil actions to compare to when deciding on the amount to be awarded. Effectively, this settlement may not only effect civil actions in the US, but also allow derivative actions to gain traction in Canada.

Penalties for violation of Canada’s Anti-Spam Legislation

More recently, the CTRC has held directors and officers personally liable for a company’s violation of CASL. On April 23, 2019, the CTRC found that a coupon marketing company, nCrowd, had violated CASL, and found the former CEO of the company to be personally liable.15 As a result, he received a CA$100,000 fine. Further, a different company that was also part of this scheme with nCrowd, had also violated CASL, and CRTC held this company’s CEO vicariously liable for the violation. As a result, he received a fine of CA$10,000. Ultimately, liability under CASL can extend beyond the corporation if the person authorized, acquiesced or participated in the commission of the violation.

Key takeaways

  • Directors and officers should familiarize themselves with all regulatory guidelines to protect the company from a data breach and to avoid being personally liable for the breach;
  • D&O liability insurance does not always offer protection for cyber-related incidents or threats. It is important to confirm whether this is protected and the scope of protection provided. Not having proper protection could expose directors and officers to liability and significant payouts;
  • There have been no derivative action attempts relating to cybersecurity breaches in Canada, but given the current climate in the US, it is possible this will encourage such claims to occur in Canada; and
  • Directors and officers can be held either personally or vicariously liable for a company’s violation of CASL if that individual played some role in the commission of the violation.

Conclusion

Cybersecurity attacks and data breaches are inevitable and can happen to any organization, thus remaining a significant threat to corporate governance. While a cybersecurity attack is a crime, directors and officers may still be held liable for a breach if they failed to oversee the company’s security measures prior to the breach, or failed to take the necessary course of action after the breach occurred. Ultimately, boards of organizations must recognize the current cybersecurity environment that exists, and assemble a reasonable response plan to respond to these threats when and if they occur. Our final article will provide key takeaways and best practices for both insureds and insurers in relation to cybersecurity risks.

A special thank you to Emeleigh Moulton (summer student) for her assistance with this article.

About Dentons

Dentons is the world’s first polycentric global law firm. A top 20 firm on the Acritas 2015 Global Elite Brand Index, the Firm is committed to challenging the status quo in delivering consistent and uncompromising quality and value in new and inventive ways. Driven to provide clients a competitive edge, and connected to the communities where its clients want to do business, Dentons knows that understanding local cultures is crucial to successfully completing a deal, resolving a dispute or solving a business challenge. Now the world’s largest law firm, Dentons’ global team builds agile, tailored solutions to meet the local, national and global needs of private and public clients of any size in more than 125 locations serving 50-plus countries. www.dentons.com

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances. Specific Questions relating to this article should be addressed directly to the author.

Subscribe To Our Newsletter

Join our mailing list to receive the latest news and updates from ILSTV

You have Successfully Subscribed!

Pin It on Pinterest