hordruma/ontario_laws_and_regs huggingface dataset:
PART VII ACCIDENT AND SICKNESS INSURANCE
Failure to disclose
309 (1) Subject to section 312 and subsections (2) to (4), when a contract, including renewals of the contract, or an addition, increase or change referred to in subsection 308 (3) has been in effect for two years with respect to a person whose life or well-being, or whose life and well-being, are insured under the contract, a failure to disclose, or a misrepresentation of, a fact required by section 308 to be disclosed in respect of that person does not, in the absence of fraud, render the contract voidable. 2012, c. 8, Sched. 23, s. 50; 2013, c. 2, Sched. 8, s. 25. Same — group insurance or creditor’s group insurance (2) In the case of a contract of group insurance or of creditor’s group insurance, a failure to disclose, or a misrepresentation of, a fact required by section 308 to be disclosed in respect of a group person insured, a person insured or a debtor insured under the contract does not render the contract voidable, but, (a)  if the failure to disclose or misrepresentation relates to evidence of insurability specifically requested by the insurer at the time of application for the insurance in respect of the person, the insurance in respect of that person is voidable by the insurer; and (b)  if the failure to disclose or misrepresentation relates to evidence of insurability specifically requested by the insurer at the time of application for an addition, increase or change referred to in subsection 308 (2) in respect of the person, the addition, increase or change in respect of that person is voidable by the insurer, unless the insurance, addition, increase or change has been in effect for two years during the lifetime of that person, in which case the insurance, addition, increase or change is not, in the absence of fraud, voidable.  2012, c. 8, Sched. 23, s. 50. Exception (3) Where a claim arises from a loss incurred or a disability beginning before a contract, including renewals of it, has been in effect for two years with respect to the person in respect of whom the claim is made, subsection (1) does not apply to that claim.  2012, c. 8, Sched. 23, s. 50. Same (4) Where a claim arises from a loss incurred or a disability beginning before the addition, increase or change has been in effect for two years with respect to the person in respect of whom the claim is made, subsection (1) does not apply to that claim.  2012, c. 8, Sched. 23, s. 50. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 50 - 01/07/2016 2013, c. 2, Sched. 8, s. 25 (1, 2) - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Application of incontestability to reinstatement
310 Sections 308 and 309 apply with necessary modifications to a failure at the time of reinstatement of a contract to disclose or a misrepresentation at that time, and the period of two years to which reference is made in section 309 commences to run in respect of a reinstatement from the date of reinstatement.  R.S.O. 1990, c. I.8, s. 310.
PART VII ACCIDENT AND SICKNESS INSURANCE
Pre-existing conditions
311 Where a contract contains a general exception or reduction with respect to pre-existing disease or physical conditions and the person insured, group person insured or debtor insured suffers or has suffered from a disease or physical condition that existed before the date the contract came into force with respect to that person and the disease or physical condition is not by name or specific description excluded from the insurance respecting that person, (a)  the prior existence of the disease or physical condition is not, except in the case of fraud, available as a defence against liability in whole or in part for a loss incurred or a disability beginning after the contract, including renewals thereof, has been in force continuously for two years immediately prior to the date of loss incurred or commencement of disability with respect to that person; and (b)  the existence of the disease or physical condition is not, except in the case of fraud, available as a defence against liability in whole or in part if the disease or physical condition was disclosed in the application for the contract. R.S.O. 1990, c. I.8, s. 311; 2012, c. 8, Sched. 23, s. 51. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 51 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Misstatement of age
312 (1) Subject to subsections (2) and (3), if the age of the person insured has been misstated to the insurer then, at the option of the insurer, either, (a)  the benefits payable under the contract shall be increased or decreased to the amount that would have been provided for the same premium at the correct age; or (b)  the premium may be adjusted in accordance with the correct age as of the date the person insured became insured. R.S.O. 1990, c. I.8, s. 312 (1). Misstatement of age in group insurance or creditor’s group insurance (2) In the case of a contract of group insurance or creditor’s group insurance, if there is a misstatement to the insurer of the age of a group person insured, person insured or debtor insured, the provisions, if any, of the contract with respect to age or misstatement of age shall apply.  2012, c. 8, Sched. 23, s. 52. True age governs (3) Where the age of a person affects the commencement or termination of the insurance, the true age governs. R.S.O. 1990, c. I.8, s. 312 (3). Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 52 - 01/07/2016 Beneficiaries
PART VII ACCIDENT AND SICKNESS INSURANCE
Meaning of “heirs”, etc.
314 (1) A designation in favour of the “heirs”, “next of kin” or “estate”, or the use of words of like import in a designation shall be deemed to be a designation of the personal representative. R.S.O. 1990, c. I.8, s. 314 (1). Death of beneficiary before insured (2) Where a beneficiary predeceases the person insured or group person insured, as the case may be, and no disposition of the share of the deceased beneficiary in the insurance money is provided in the contract or by declaration, the share is payable, (a)  to the surviving beneficiary; or (b)  if there is more than one surviving beneficiary, to the surviving beneficiaries in equal shares; or (c)  if there is no surviving beneficiary, to the insured or group person insured, as the case may be, or his or her personal representative. R.S.O. 1990, c. I.8, s. 314 (2). Right to sue (3) A beneficiary may enforce for the beneficiary’s own benefit, and a trustee appointed under section 315 may enforce as trustee, the payment of insurance money payable to him, her or it, but the insurer may set up any defence that it could have set up against the insured or the insured’s personal representative.  2012, c. 8, Sched. 23, s. 54. Two or more designated beneficiaries (4) Where two or more beneficiaries are designated otherwise than alternatively but no division of the insurance money is made, the insurance money is payable to them in equal shares.  2012, c. 8, Sched. 23, s. 54. Disclaimer by beneficiary (5) A beneficiary may disclaim the beneficiary’s right to insurance money by filing notice in writing with the insurer at its head or principal office in Canada.  2012, c. 8, Sched. 23, s. 54. Same (6) A notice of disclaimer filed under subsection (5) is irrevocable.  2012, c. 8, Sched. 23, s. 54. Same (7) Subsection (2) applies in the case of a disclaiming beneficiary or in the case of a beneficiary determined by a court to be disentitled to insurance money as if the disclaiming or disentitled beneficiary predeceased the person whose life or well-being, or whose life and well-being, are insured.  2012, c. 8, Sched. 23, s. 54. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 54 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Irrevocable designation
314.1 (1) An insured may in a contract or by a declaration, other than a declaration that is part of a will, filed with the insurer at its head or principal office in Canada during the lifetime of the person whose life or well-being, or whose life and well-being, are insured, designate a beneficiary irrevocably, and in that event the insured, while the beneficiary is living, may not alter or revoke the designation without the consent of the beneficiary, and the insurance money is not subject to the control of the insured or the claims of the insured’s creditors and does not form part of the insured’s estate.  2012, c. 8, Sched. 23, s. 55. Failure to file designation with insurer (2) If an insured purports to designate a beneficiary irrevocably in a will or in a declaration that is not filed with the insurer, the designation has the same effect as if the insured had not purported to make it irrevocable.  2012, c. 8, Sched. 23, s. 55. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 55 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Trustee for beneficiary
315 (1) An insured may in a contract or by a declaration appoint a trustee for a beneficiary, and may alter or revoke the appointment by a declaration.  R.S.O. 1990, c. I.8, s. 315. Payment to trustee discharges insurer (2) A payment made by an insurer to a trustee for a beneficiary discharges the insurer to the extent of the amount of the payment.  2012, c. 8, Sched. 23, s. 56. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 56 - 01/07/2016 Documents affecting title and assignment of contracts
PART VII ACCIDENT AND SICKNESS INSURANCE
Documents affecting right to insurance money
316 (1) Until an insurer receives at its head or principal office in Canada an instrument or an order of any court of competent jurisdiction affecting the right to receive insurance money, or a notarial copy or a copy verified by statutory declaration of any such instrument or order, it may make payment of the insurance money and shall be as fully discharged to the extent of the amount paid as if there were no such instrument or order. R.S.O. 1990, c. I.8, s. 316 (1). Saving (2) Subsection (1) does not affect the rights or interests of any person other than the insurer. R.S.O. 1990, c. I.8, s. 316 (2). Interest of assignee (3) Where an assignee of a contract gives notice in writing of the assignment to the insurer at its head or principal office in Canada the assignee has priority of interest as against, (a)  any assignee other than one who gave notice earlier in like manner; and (b)  a beneficiary other than one designated irrevocably as provided in section 314.1 before the assignee gave notice to the insurer of the assignment in the manner provided for in this subsection. R.S.O. 1990, c. I.8, s. 316 (3); 2012, c. 8, Sched. 23, s. 57 (1). Effect of assignment (3.1) Where a contract is assigned as security, the rights of a beneficiary under the contract are affected only to the extent necessary to give effect to the rights and interests of the assignee. 2012, c. 8, Sched. 23, s. 57 (2). Assignee deemed to be insured (4) Where a contract is assigned unconditionally and otherwise than as security, the assignee has all the rights and interests given by the contract and by this Part to the insured, and shall be deemed to be the insured. R.S.O. 1990, c. I.8, s. 316 (4). Same (4.1) Unless the document by which a contract is assigned specifies otherwise, an assignment described in subsection (4) made on or after the date this section comes into force revokes, (a)  a designation of a beneficiary made before or after that date and not made irrevocably; and (b)  a nomination referred to in section 317.3 made before or after that date.  2012, c. 8, Sched. 23, s. 57 (2). Prohibition against assignment (5) A provision in a contract to the effect that the rights or interests of the insured, or in the case of a contract of group insurance or of creditor’s group insurance, the group person insured or debtor insured, are not assignable is valid.  2012, c. 8, Sched. 23, s. 57 (3). Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 57 (1-3) - 01/07/2016 Insurance money free from other claims, etc.
PART VII ACCIDENT AND SICKNESS INSURANCE
Claims by creditors
317 (1) Where a beneficiary is designated, any insurance money payable to the beneficiary is not, from the time of the happening of the event upon which it becomes payable, part of the estate of the insured and is not subject to the claims of the creditors of the insured.  R.S.O. 1990, c. I.8, s. 317 (1). Contract exempt from seizure (2) While there is in effect a designation of beneficiary in favour of any one or more of a spouse, child, grandchild or parent of the person insured or group person insured, the insurance money and the rights and interests of the insured in the insurance money and in the contract so far as either relate to accidental death benefits are exempt from execution or seizure.  R.S.O. 1990, c. I.8, s. 317 (2); 1999, c. 6, s. 31 (12); 2005, c. 5, s. 35 (16); 2012, c. 8, Sched. 23, s. 58; 2021, c. 4, Sched. 11, s. 19. Section Amendments with date in force (d/m/y) 1999, c. 6, s. 31 (12) - 01/03/2000 2005, c. 5, s. 35 (16) - 09/03/2005 2012, c. 8, Sched. 23, s. 58 - 01/07/2016 2021, c. 4, Sched. 11, s. 19 - 19/04/2021
PART VII ACCIDENT AND SICKNESS INSURANCE
Assignment of insurance
317.1 (1) The insured may assign, exercise rights under or in respect of, surrender or otherwise deal with the contract as provided in the contract or in this Part or as may be agreed on with the insurer if a beneficiary, (a)  is not designated irrevocably; or (b)  is designated irrevocably but has attained the age of 18 years and consents.  2012, c. 8, Sched. 23, s. 59. Where there is an irrevocable designation of beneficiary (2) Despite subsection 314.1 (1), if a beneficiary is designated irrevocably and has not consented as described in clause (1) (b), the insured may exercise any rights in respect of the contract that are prescribed by Authority rule.  2012, c. 8, Sched. 23, s. 59; 2017, c. 34, Sched. 21, s. 24. Same (3) Subject to the terms of a consent under clause (1) (b) or an order of the court under subsection (4), if there is an irrevocable designation of a beneficiary under a contract, a person acquiring an interest in the contract takes that interest subject to the rights of that beneficiary.  2012, c. 8, Sched. 23, s. 59. Same (4) When a beneficiary who is designated irrevocably is unable to provide consent under clause (1) (b) because of legal incapacity, an insured may apply to the court for an order permitting the insured to deal with the contract without that consent.  2012, c. 8, Sched. 23, s. 59. Same (5) The court may grant an order under subsection (4) on any notice and terms it considers just.  2012, c. 8, Sched. 23, s. 59. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 59 - 01/07/2016 2017, c. 34, Sched. 21, s. 24 - 08/06/2019 CTS 04 SE 18 - 1
PART VII ACCIDENT AND SICKNESS INSURANCE
Entitlement to dividends
317.2 (1) Despite the irrevocable designation of a beneficiary, the insured is entitled, before his or her death, to the dividends or bonuses declared on a contract unless the contract provides otherwise.  2012, c. 8, Sched. 23, s. 59. Same (2) Unless the insured directs otherwise, the insurer may apply the dividends or bonuses declared on the contract for the purposes of keeping the contract in force.  2012, c. 8, Sched. 23, s. 59. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 59 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Transfer of ownership
317.3 (1) Despite the Succession Law Reform Act, if in a contract or declaration it is provided that a person named in the contract or declaration has, on the death of the insured, the rights and interests of the insured in the contract, (a)  the rights and interests of the insured in the contract do not, on the death of the insured, form part of the insured’s estate; and (b)  on the death of the insured, the person named in the contract or declaration has the rights and interests given to the insured by the contract and by this Part and shall be deemed to be the insured.  2012, c. 8, Sched. 23, s. 60. Successive owners (2) Where a contract or declaration referred to in subsection (1) provides that, on the death of the insured, two or more persons named in the contract or declaration have successively on the death of each of them the rights and interests of the insured in the contract, this section applies successively, with all necessary modifications, to each of those persons and their rights and interests in the contract.  2012, c. 8, Sched. 23, s. 60. Saving (3) Despite a nomination referred to in subsection (1), the insured, before his or her death, may, (a)  assign, exercise rights under or in respect of, surrender or otherwise deal with the contract as if the nomination had not been made; and (b)  subject to the terms of the contract, alter or revoke the nomination by declaration.  2012, c. 8, Sched. 23, s. 60. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 60 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Group person insured enforcing rights
318 A group person insured may, in his or her own name, enforce a right given by a contract to him or her, or to a person insured thereunder as a person dependent upon or related to him or her, subject to any defence available to the insurer against him or her or such person insured or against the insured.  R.S.O. 1990, c. I.8, s. 318.
PART VII ACCIDENT AND SICKNESS INSURANCE
Enforcement of right re creditor’s group insurance
318.1 (1) A debtor insured or a debtor who is jointly liable for the debt with the debtor insured may enforce in his or her own name the creditor’s rights in respect of a claim arising in relation to the debtor insured, subject to any defence available to the insurer against the creditor or the debtor insured.  2012, c. 8, Sched. 23, s. 61. Payment by insurer to creditor (2) Subject to subsection (3), if an insurer pays insurance money in respect of a claim under subsection (1), the insurer shall pay the insurance money to the creditor.  2012, c. 8, Sched. 23, s. 61. Excess may be paid to debtor insured (3) If the debtor insured provides evidence satisfactory to the insurer that the insurance money exceeds the debt then owing to the creditor, the insurer may pay the excess directly to that debtor insured.  2012, c. 8, Sched. 23, s. 61. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 61 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Simultaneous deaths
319 Unless a contract or a declaration otherwise provides, where a person insured or group person insured and a beneficiary die at the same time or in circumstances rendering it uncertain which of them survived the other, the insurance money and any applicable interest are payable as if the beneficiary had predeceased the person insured or group person insured. R.S.O. 1990, c. I.8, s. 319; 2012, c. 8, Sched. 23, s. 62. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 62 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Payment into court
320 (1) Where the insurer admits liability for the insurance money or any part thereof and it appears to the insurer that, (a)  there are adverse claimants; (b)  the whereabouts of the person entitled is unknown; (c)  there is no person capable of giving or authorized to give a valid discharge therefor who is willing to do so; (d)  there is no person entitled to the insurance money; or (e)  the person to whom the insurance money is payable would be disentitled on public policy or other grounds, the insurer may apply without notice to the court for an order for payment of money into court, and the court may upon such notice, if any, as it deems necessary, make an order accordingly. R.S.O. 1990, c. I.8, s. 320 (1); 2012, c. 8, Sched. 23, s. 63. Costs of proceedings (2) The court may fix without assessment the costs incurred upon or in connection with any application or order made under subsection (1), and may order the costs to be paid out of the insurance money or by the insurer or otherwise as it considers just. R.S.O. 1990, c. I.8, s. 320 (2). Discharge of insurer (3) A payment made pursuant to an order under subsection (1) discharges the insurer to the extent of the payment. R.S.O. 1990, c. I.8, s. 320 (3). Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 63 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Where beneficiary a minor
321 (1) Where an insurer admits liability for insurance money payable to a minor and there is no person capable of giving and authorized to give a valid discharge therefor who is willing to do so, the insurer may at any time after thirty days from the date of the happening of the event upon which the insurance money becomes payable, pay the money into court to the credit of the minor. R.S.O. 1990, c. I.8, s. 321 (1); 2012, c. 8, Sched. 23, s. 64 (1). (2) Repealed: 2012, c. 8, Sched. 23, s. 64 (2). Procedure (3) No order is necessary for payment into court under subsection (1), but the accountant or other proper officer shall receive the money upon the insurer filing with him or her an affidavit showing the amount payable and the name, date of birth and residence of the minor, and upon such payment being made the insurer shall forthwith notify the Children’s Lawyer and deliver to him or her a copy of the affidavit. R.S.O. 1990, c. I.8, s. 321 (3); 1994, c. 27, s. 43 (2). Insurer discharged by payment into court (4) Payment of the money into court in accordance with this section discharges the insurer to the extent of the payment.  2012, c. 8, Sched. 23, s. 64 (3). Authorized payments (5) An insurer may, despite subsection (1), pay insurance money and applicable interest payable to a minor to, (a)  the guardian of the property of the minor, appointed under section 47 of the Children’s Law Reform Act; or (b)  a person referred to in subsection 51 (1) of the Children’s Law Reform Act, if the payment does not exceed the amount set out in that subsection.  2012, c. 8, Sched. 23, s. 64 (3). Section Amendments with date in force (d/m/y) 1994, c. 27, s. 43 (2) - 03/04/1995 2012, c. 8, Sched. 23, s. 64 (1-3) - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Beneficiary under legal incapacity
322 Despite section 321, where it appears to an insurer that a representative of a beneficiary who is a minor or otherwise under a legal incapacity may accept payments on behalf of the beneficiary under the law of the jurisdiction in which the beneficiary resides, the insurer may make payment to the representative, and the payment discharges the insurer to the extent of the amount paid.  2012, c. 8, Sched. 23, s. 65. Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 65 - 01/07/2016
PART VII ACCIDENT AND SICKNESS INSURANCE
Payments not exceeding $10,000
323 Even though insurance money is payable to a person, the insurer may if the contract so provides, but subject always to the rights of an assignee, pay an amount not exceeding $10,000 to, (a)  a relative by blood or connection by marriage of a person insured or the group person insured; or (b)  any person appearing to the insurer to be equitably entitled thereto by reason of having incurred expense for the maintenance, medical attendance or burial of a person insured or the group person insured, or to have a claim against the estate of a person insured or the group person insured in relation thereto, and any such payment discharges the insurer to the extent of the amount paid.  R.S.O. 1990, c. I.8, s. 323; 2012, c. 8, Sched. 23, s. 66; 2016, c. 23, s. 55 (5). Section Amendments with date in force (d/m/y) 2012, c. 8, Sched. 23, s. 66 - 01/07/2016 2016, c. 23, s. 55 (5)
- 01/01/2017