Marek v. RBC Life Insurance Company

Marek v. RBC Life Insurance Company

The trial judge correctly construed "loss of use" by reference to the insurance contract rather than the AMA Guidelines; the Guidelines were not incorporated and not determinative, any ambiguity about nerve damage is resolved in favour of the insured (requiring permanence if nerve-related), and the factual finding...

Source-derived case information.

Citation
2008 ONCA 387
Parties
Plaintiff (respondent): John Marek; Defendant (appellant): RBC Life Insurance Company
Court
Court of Appeal for Ontario
Jurisdiction
Canada
Judgment Date
14 May 2008
Procedural Posture
Civil / Appeal; Court of Appeal Decision
Outcome
Appeal dismissed
Legal Topics
Loss of Use, Policy Interpretation, Ambiguity in Insurance Contracts, American Medical Association Guidelines, Nerve Damage Requirement
Source Language
english
Insurance Personal Injury Contract Interpretation Civil Procedure Loss of Use Policy Interpretation Ambiguity in Insurance Contracts American Medical Association Guidelines +1 more

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Parties

John Marek

Plaintiff (respondent)

RBC Life Insurance Company

Defendant (appellant)

Procedural Posture

Civil / Appeal; Court of Appeal Decision

Legal Issues

  1. 1 Whether the respondent suffered a "loss of use" of his foot under the accident insurance policy
  2. 2 Whether the American Medical Association (AMA) Guidelines are determinative of the meaning of "loss of use" under the contract
  3. 3 Whether nerve damage is a required element and, if so, whether it must be permanent

Ratio Decidendi

The trial judge correctly construed "loss of use" by reference to the insurance contract rather than the AMA Guidelines; the Guidelines were not incorporated and not determinative, any ambiguity about nerve damage is resolved in favour of the insured (requiring permanence if nerve-related), and the factual finding that the respondent lost total functional use of his foot was not reviewable on appeal.

Court Disposition

Appeal dismissed

Orders

  • Appeal dismissed
  • Costs to the respondent in the agreed amount of $10,000 inclusive of disbursements and G.S.T.