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B.A. v. Economical Mutual Insurance Company (18-005968)

  • August 19, 2020

The insurer denied the claim for IRBs pursuant to section 31(1)(b), arguing that the claimant had made a material misrepresentation that induced the insurer to enter into the contract. In particular, the claimant allegedly misrepresented her address for the purpose of obtaining a lower premium. As a preliminary issue, the claimant sought to exclude audio recordings between herself and her broker in which she was arranging to buy insurance. The claimant argued that the recordings were made without her consent and violated the Freedom of Information and Protection of Privacy Act. Adjudicator Johal permitted the audio recordings to be considered, noting that the Statutory Power Procedures Act allowed the Tribunal to consider any evidence unless it was inadmissible by reason of privilege. Further, the audio recordings were highly relevant to the issue in dispute. Regarding the section 31 exclusion, Adjudicator Johal concluded that the claimant did make a material misrepresentation and that the insurer was therefore not required to pay IRBs. The claimant did not make an honest mistake regarding her place of residence and knew the importance of providing her correct address to the insurance broker. Adjudicator Johal rejected the claimant’s arguments that waiver or estoppel should bar the claimant from relying on section 31 because the insurer did subsequently increase her premiums after learning of the misrepresentation. Adjudicator Johal held that the Tribunal could not exercise equitable remedies, but also noted that the claimant failed to prove the necessary factual steps to rely on either remedy.

Full decision here

TGP Analysis

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