{"id":5590,"date":"2020-07-02T07:56:51","date_gmt":"2023-08-12T08:04:04","guid":{"rendered":"https:\/\/www.millerthomson.com\/ontario-court-confirms-that-insurers-are-ultimately-liable-for-the-conduct-of-adjusters\/"},"modified":"2024-09-16T11:08:47","modified_gmt":"2024-09-16T15:08:47","slug":"ontario-court-confirms-that-insurers-are-ultimately-liable-for-the-conduct-of-adjusters","status":"publish","type":"post","link":"https:\/\/www.millerthomson.com\/en\/insights\/lloyds-brief\/ontario-court-confirms-that-insurers-are-ultimately-liable-for-the-conduct-of-adjusters\/","title":{"rendered":"Ontario court confirms that insurers are ultimately liable for the conduct of adjusters"},"content":{"rendered":"<p>In <em>Burns v RBC Life Insurance Co.<\/em>,<sup>1<\/sup> the Ontario Superior Court of Justice recently confirmed that liability ultimately rests with insurers where their employees are acting within the scope of their employment.<\/p>\n<h2>The Facts<\/h2>\n<p>In this case, the plaintiff had a disability benefits contract with the defendant, RBC Life Insurance Company (\u201cthe Insurer\u201d). The defendants, Lauren Mclean and Anna Oslizlok (\u201cthe Adjusters\u201d), were the employees of the Insurer who administered the plaintiff\u2019s disability claim.<\/p>\n<p>In September of 2012, the Insurer accepted that the plaintiff was suffering from a total disability related to an injury to his spine. The Insurer approved the payment of long-term disability (\u201cLTD\u201d) benefits to the plaintiff. Pursuant to the Insurer\u2019s policy, total disability was a requirement for the payment of LTD benefits. In 2017, Ms. Mclean advised the plaintiff that his LTD benefits were being terminated on the basis that the plaintiff had not been suffering from a total disability from 2013 onwards. Ms. Oslizlok denied the plaintiff\u2019s appeal of the termination of his LTD benefits.<\/p>\n<p>The plaintiff sued both the Insurer and the Adjusters for breach of contract, negligence, and negligent misrepresentation. Importantly, in his statement of claim, the plaintiff did not distinguish between the conduct of the Insurer and the individual conduct of the adjusters.<\/p>\n<h2>The Court\u2019s Ruling on the Personal Liability of the Adjusters<\/h2>\n<p>This decision dealt with the adjusters\u2019 motion to strike the claim against them as disclosing no reasonable cause of action. On this type of motion, the Court accepts the pleaded allegations of fact in the statement of claim as proven unless they are patently ridiculous and incapable of proof. The Court concluded that the plaintiff had not pleaded the necessary material facts to make out a claim against the Adjusters in their personal capacity. In the result, the Court struck out the statement of claim against the Adjusters without leave to amend.<\/p>\n<p>In its decision, the Court canvassed recent Court of Appeal decisions relating to the personal liability of employees. The Court observed that it is well-established that an employee may only be liable in their personal capacity where the conduct of the employee manifests a separate identity and interest from the employer and the employee\u2019s actions are themselves tortious. Further, the Court confirmed that insurance adjusters do not owe an independent duty of good faith to an insured. The Court concluded that the plaintiff\u2019s statement of claim failed to plead any facts suggesting that the Adjusters\u2019 alleged misconduct manifested a separate identity from the Insurer.<\/p>\n<h2>What Does this Mean for Insurers?<\/h2>\n<p>In this decision, the Court confirmed that only in egregious circumstances will an adjuster be exposed to personal liability for their conduct. Liability for the administration of claims ultimately lies with the insurer, who may be vicariously liable for the conduct of the adjusters they employ.<\/p>\n<ol>\n<li>2019 ONSC 6977 (released on December 3, 2019).<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>In Burns v RBC Life Insurance Co.,1 the Ontario Superior Court of Justice recently confirmed that liability ultimately rests with insurers where their employees are acting within the scope of their employment. The Facts In this case, the plaintiff had a disability benefits contract with the defendant, RBC Life Insurance Company (\u201cthe Insurer\u201d). The defendants, [&hellip;]<\/p>\n","protected":false},"author":100,"featured_media":14371,"parent":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[536],"insight-format":[416],"class_list":["post-5590","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lloyds-brief"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.1.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ontario court confirms that insurers are ultimately liable for the conduct of adjusters | Miller Thomson<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.millerthomson.com\/en\/insights\/lloyds-brief\/ontario-court-confirms-that-insurers-are-ultimately-liable-for-the-conduct-of-adjusters\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ontario court confirms that insurers are ultimately liable for the conduct of adjusters | Miller Thomson\" \/>\n<meta property=\"og:description\" content=\"In Burns v RBC Life Insurance Co.,1 the Ontario Superior Court of Justice recently confirmed that liability ultimately rests with insurers where their employees are acting within the scope of their employment. The Facts In this case, the plaintiff had a disability benefits contract with the defendant, RBC Life Insurance Company (\u201cthe Insurer\u201d). The defendants, [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.millerthomson.com\/en\/insights\/lloyds-brief\/ontario-court-confirms-that-insurers-are-ultimately-liable-for-the-conduct-of-adjusters\/\" \/>\n<meta property=\"og:site_name\" content=\"Miller Thomson\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/MillerThomsonLaw\/\" \/>\n<meta property=\"article:published_time\" content=\"2023-08-12T08:04:04+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-09-16T15:08:47+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.millerthomson.com\/wp-content\/uploads\/2024\/10\/Insights_Lloyd-s-Brief_Post-Image.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1776\" \/>\n\t<meta property=\"og:image:height\" content=\"994\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"believeco\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" 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