Canada Judgment

Supreme Court of British Columbia

Napoleone v. Sharma

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Research organized from the available case record

Source document

01

Holding and result

The private insurance exception does not apply because the plaintiff failed to prove that she or her husband paid for or provided consideration for the extended health benefits; therefore the plaintiff is entitled only to the net cost of special expenses and not the gross amount, and the claim for gross costs is dismissed.

Court disposition

Claim for gross cost of special expenses dismissed; plaintiff entitled only to net cost of special expenses.

Orders

  • Dismissal of plaintiff's claim for the gross cost of special expenses.
  • Plaintiff awarded only the net cost of special expenses (insurer-covered portion excluded).

02

Material facts

Parties

Gisella Napoleone

Plaintiff Counsel: T. Spraggs, O. Wilson

Jaspal Sharma

Defendant Counsel: S. Avram

Amounts and remedies

  • Insured Coverage Percent: 80

03

Procedural history

  1. Posture

    Motor Vehicle Negligence / Personal Injury / Reasons for Judgment on Damages (written Submissions Considered)

04

Questions and positions

Legal issues

Party arguments

Applicant
Plaintiff contends the private insurance exception applies and seeks recovery of the gross cost of special expenses, relying on Cunningham v. Wheeler, Brennan v. Singh and Kean v. Porter.
Respondent
Defendant contends the private insurance exception is inapplicable because there is no evidence that the plaintiff or her husband paid for the insurance benefits or that consideration was provided; relies on Cunningham and Ratych v. Bloomer.

05

Court’s reasoning

  1. 01

    Cunningham v. Wheeler, [1994] 1 S.C.R. 359 (para. 5, McLachlin J.)

    Damages for negligence are compensatory only — plaintiff entitled to be restored to position she would have been in absent the accident.

  2. 02

    Cunningham v. Wheeler, [1994] 1 S.C.R. 359 (para. 75) adopting Bradburn v. Great Western Rail Co., [1874-80] All E.R. 195

    Private insurance exception permits recovery of insured amounts as not to be set off against damages where plaintiff paid for the insurance (prudence/deprivation rationale).

  3. 03

    Cunningham v. Wheeler, [1994] 1 S.C.R. 359 (para. 94); Ratych v. Bloomer, [1990] 1 S.C.R. 940

    Onus is on plaintiff to establish that she paid for the provision of the insurance benefits (directly or indirectly) before the private insurance exception applies.

06

Ratio, limits and disposition

Ratio decidendi

The private insurance exception does not apply because the plaintiff failed to prove that she or her husband paid for or provided consideration for the extended health benefits; therefore the plaintiff is entitled only to the net cost of special expenses and not the gross amount, and the claim for gross costs is dismissed.

Obiter and limits

  • It is irrelevant that benefits were secured through the plaintiff's husband for the exception to apply if payment/consideration is proven (citing Brennan).
  • No evidence was led regarding whether the insurer has a subrogation claim.
  • The plan covered 80% of the plaintiff's physiotherapy and massage costs but there was no evidence of who paid premiums or whether benefits were negotiated or deducted from wages.

Court disposition

Claim for gross cost of special expenses dismissed; plaintiff entitled only to net cost of special expenses.

  • Dismissal of plaintiff's claim for the gross cost of special expenses.
  • Plaintiff awarded only the net cost of special expenses (insurer-covered portion excluded).

Source and reliance status

Supreme Court of British Columbia · 18 December 2008

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Judgment text

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Source document

Supreme Court of British Columbia

Judgment· 18 December 2008

2008 BCSC 1746

2008 BCSC 1746 Napoleone v. Sharma

IN THE SUPREME COURT OF BRITISH COLUMBIA Citation: Napoleone v. Sharma, 2008 BCSC 1746 Date: 20081218 Docket: M102498 Registry: New Westminster Between: Gisella Napoleone Plaintiff And Jaspal Sharma Defendant Before: The Honourable Madam Justice Bruce Reasons for Judgment Counsel for the Plaintiff T. Spraggs, O. Wilson Counsel for the Defendant S. Avram Date and Place of Trial/Hearing: Written Submissions New Westminster, B.C.

INTRODUCTION [1] On November 12, 2008 I issued reasons for decision in regard to the plaintiff's claim for damages arising out of a motor vehicle accident. In these reasons I asked for written submissions on the narrow issue of whether the plaintiff was entitled to the net or the gross cost of special expenses such as physiotherapy, massage therapy, and prescription medications. [2] Both parties provided written submissions within the thirty day deadline. I have reviewed these submissions and have determined that Ms. Napoleone is only entitled to receive the net cost of the special expenses. She is not entitled to be compensated for that portion of the special expenses covered by a private insurer. These are the reasons for my decision.

BACKGROUND [3] Ms. Napoleone was injured in a motor vehicle accident on January 7, 2006 in Surrey, BC. As a consequence of this accident she suffered soft tissue injuries that were treated with physiotherapy and massage therapy. Ms. Napoleone's physician also prescribed medication for the pain and to help her sleep. [4] Ms. Napoleone testified that through her husband's employment she was covered on extended health plan that paid 80% of the cost of physiotherapy and massage therapy. There was no evidence as to who was responsible for the cost of this insurance plan or how her husband came to be covered by the plan. There was also no evidence as to whether the insurer had a claim for subrogation in the event Ms. Napoleone was awarded compensation for these expenses.

ARGUMENT [5] Ms. Napoleone argues that the insurance exception to the general rule against doubt recovery is applicable to this case. In support of this proposition, Ms. Napoleone relies upon Cunningham v. Wheeler, [1994] 1 S.C.R. 359, Brennan v. Singh (1999), 86 A.C.W.S. (3d) 537 (S.C.), and Kean v. Porter, 2008 BCSC 1594. [6] The defendant argues the insurance exception is not available to Ms. Napoleone because there is no evidence that she or her husband paid for the insurance benefits by any means. In support of this proposition, the defendant relies upon Cunningham and Ratych v. Bloomer, [1990] 1 S.C.R.

940.

DECISION [7] The general rule in an action for damages arising out of negligence is that the plaintiff is only entitled to be restored to the position she would have been in had the accident not occurred. The plaintiff is awarded damages for her actual loss and no more: Cunningham at para. 5 per McLachlin J. (dissenting in part) [8] The law has recognized a limited exception to the rule against double recovery which is referred to as the "private insurance" exception. In Cunningham at para. 75 Mr. Justice Cory, speaking for the majority, adopts the following passage from Bradburn v. Great Western Rail Co., [1874-80] All E.R. 195 as accurately describing the underlying rationale for the exception: I think that there would be no justice or principle in setting off an amount which the plaintiff has entitled himself to under a contract of insurance, such as any prudent man would make on the principle of, as the expression is, "laying away for a rainy day". He pays the premiums upon a contract which, if he meets with an accident, entitles him to receive a sum of money. It is not because he meets with the accident, but because he made a contract with, and paid premiums to, the insurance company, for that express purpose, that he gets the money from them. and I think that it ought not, upon any principle of justice, to be deducted from the amount of damages proved to have been

sustained by him through the negligence of the defendant. [9] Whether the plaintiff has paid for private insurance or has obtained these benefits through an employment contract, the exception will apply. It is also irrelevant that it is the plaintiff's husband who secured these benefits. See, Brennan at para. 182-3. However, the onus rests with the plaintiff to prove he or she has paid for the provision of insurance benefits in some fashion. As Cory J. says in Cunningham at para. 94: In my view, Ratych v. Bloomer, supra, simply placed an evidentiary burden upon plaintiffs to establish that they had paid for the provision of disability benefits. I think the manner of payment may be found, for example, in evidence pertaining to the provisions of a collective bargaining agreement just as clearly as in a direct payroll deduction. [10] There is no evidence before the court as to what, if any, consideration passed between Mr. Napoleone and his employer in respect of the extended health benefits. There is no evidence of whether Mr. Napoleone pays all or a portion of the insurance cost or whether it was negotiated as a part of a collective bargaining scheme. The only evidence before the court is that the plan was secured through Mr. Napoleone's employer and it covers 80% of Mrs. Napoleone's health related expenses. [11] Without an evidentiary foundation to support the claim, I am

unable to apply the private insurance exception to the case at hand. As Cory J. says at para. 93 of Cunningham, it is only when this evidentiary requirement is met that the court may be satisfied the plaintiff has shown the prudence and corresponding deprivation that underlies the exception and permits double recovery. [12] For these reasons, I must dismiss Ms. Napoleone's claim for the gross cost of the special expenses. "Bruce J."

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Authorities

Authorities used by the court

Cases, legislation, regulations, and constitutional provisions identified in the available record.

Napoleone v. Sharma, 2008 BCSC 1746

Case cited

Cunningham v. Wheeler, [1994] 1 S.C.R. 359

Case cited

Brennan v. Singh (1999), 86 A.C.W.S. (3d) 537 (S.C.)

Case cited

Kean v. Porter, 2008 BCSC 1594

Case cited

Ratych v. Bloomer, [1990] 1 S.C.R. 940

Case cited

Bradburn v. Great Western Rail Co., [1874-80] All E.R. 195

Case cited

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