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This Act is current to May 9, 2018
See the Tables of Legislative Changes for this Act’s legislative history, including any changes not in force.

Insurance Act

[RSBC 2012] CHAPTER 1

Deposited with Clerk of the Legislative
Assembly on June 21, 2012

Part 4 — Accident and Sickness Insurance

Definitions

92   In this Part:

"application" means an application for insurance or for the reinstatement of insurance;

"beneficiary" means a person, other than the insured or the insured's personal representative, to whom or for whose benefit insurance money is made payable in a contract or by a declaration;

"blanket insurance" means group insurance that covers loss

(a) arising from specific hazards incidental to or defined by reference to a particular activity or activities, and

(b) occurring during a limited or specified period not exceeding 6 months in duration;

"contract" means a contract of insurance;

"creditor's group insurance" means insurance effected by a creditor under which the lives or well being or both of a number of the creditor's debtors are insured severally under a single contract;

"debtor insured" means a debtor whose life or well being or both are insured under a contract of creditor's group insurance;

"declaration", except in sections 104 and 123, means an instrument signed by the insured

(a) with respect to which an endorsement is made on the policy,

(b) that identifies the contract, or

(c) that describes the insurance or insurance fund or a part of the insurance or insurance fund,

in which the insured

(d) designates, or alters or revokes the designation of, the insured, the insured's personal representative or a beneficiary as one to whom or for whose benefit insurance money is to be payable, or

(e) makes, alters or revokes an appointment under section 120 (1) or a nomination referred to in section 127;

"family insurance" means insurance under which the lives or well being or both of the insured and one or more persons related to the insured by blood, marriage or adoption or because of a marriage-like relationship, including a marriage-like relationship between persons of the same gender, are insured under a single contract between an insurer and the insured;

"fraternal society" means a society, order or association incorporated for the purpose of making with its members only, and not for profit, contracts of life insurance and accident and sickness insurance in accordance with its constitution, bylaws and rules and this Act;

"group insurance" means insurance other than creditor's group insurance and family insurance under which the lives or well being or both of a number of persons are insured severally under a single contract between an insurer and an employer or other person;

"group person insured" means a person, called the "primary person", whose life or well being or both are insured under a contract of group insurance, but does not include a person whose life or well being or both are insured under the contract as a person dependent on or related to the primary person;

"instrument" includes a will;

"insurance" means accident and sickness insurance;

"insured" means

(a) in the case of group insurance, in the provisions of this Part relating to the designation of beneficiaries or personal representatives as recipients of insurance money and their rights and status, the group person insured, and

(b) in all other cases, the person who makes a contract with an insurer;

"person insured" means a person in respect of an accident to whom, or in respect of whose sickness, insurance money is payable under a contract, but does not include a group person insured or debtor insured;

"spouse" means a person who

(a) is married to another person, or

(b) is living with another person in a marriage-like relationship;

"will" includes a codicil.

Application of Part 2

93   Sections 13 and 14 apply to contracts of accident and sickness insurance.

Application of this Part

94   (1) Despite any agreement, condition or stipulation to the contrary, but subject to regulations under section 150 of this Act and section 103 of the Insurance Amendment Act, 2009, this Part applies to a contract made in British Columbia on and after October 1, 1970 and sections 92 to 96, 103, 107 to 110, 114 and 117 to 139 apply also to a contract made in British Columbia before that day.

(2) Sections 178 to 181, 183, 190 and 193 of Part V of the Insurance Act, R.S.B.C. 1979, c. 200, in force immediately before October 1, 1970 apply to a contract made in British Columbia before that day.

(3) This Part does not apply to either of the following:

(a) except as otherwise provided by regulation, insurance that is part of a contract of life insurance under which the insurer undertakes to pay insurance money, or to provide other benefits, in the event the person whose life is insured becomes disabled as a result of bodily injury or disease;

(b) insurance that is part of a contract of life insurance under which the insurer undertakes to pay an additional amount of insurance money in the event of death by accident of the person whose life is insured.

Application of this Part to group insurance

95   In the case of a contract of group insurance made with an insurer authorized to transact insurance in British Columbia at the time the contract was made, this Part applies in determining

(a) the rights and status of beneficiaries and personal representatives as recipients of insurance money, if the group person insured was resident in British Columbia at the time he or she became insured, and

(b) the rights and obligations of the group person insured if he or she was resident in British Columbia at the time he or she became insured.

Issuance and furnishing of policy

96   (1) An insurer entering into a contract must

(a) issue a policy, and

(b) furnish to the insured the policy and a copy of the insured's application.

(2) Subject to subsection (3), the provisions in

(a) the application,

(b) the policy,

(c) any document attached to the policy when issued, and

(d) any amendment to the contract agreed on in writing after the policy is issued

constitute the entire contract.

(3) In the case of a contract made by a fraternal society, the policy, the Act or instrument of incorporation of the society, its constitution, bylaws and rules, and the amendments made to any of them, the application for the contract and the medical statement of the applicant constitute the entire contract.

(4) Except in the case of a contract of group insurance or creditor's group insurance, an insurer, on request, must furnish to the insured or a claimant under the contract a copy of

(a) the entire contract as set out in subsection (2) or (3), as applicable, and

(b) any written statement or other record provided to the insurer as evidence of insurability under the contract.

(5) In the case of a contract of group insurance, an insurer,

(a) on request, must furnish to a group person insured or claimant under the contract, a copy of

(i) the group person insured's application, and

(ii) any written statement or other record, not otherwise part of the application, provided to the insurer as evidence of the insurability of the group person insured under the contract, and

(b) on request and reasonable notice, must permit a group person insured or claimant under the contract to examine, and must furnish to that person, a copy of the policy of group insurance.

(6) In the case of a contract of creditor's group insurance, an insurer,

(a) on request, must furnish to a debtor insured or claimant under the contract a copy of

(i) the debtor insured's application, and

(ii) any written statement or other record, not otherwise part of the application, provided to the insurer as evidence of the insurability of the debtor insured under the contract, and

(b) on request and reasonable notice, must permit a debtor insured or claimant under the contract to examine, and must furnish to that person, a copy of the policy of creditor's group insurance.

(7) An insurer may charge a reasonable fee to cover its expenses in furnishing copies of documents under subsection (4), (5) or (6), other than the first copy furnished to each person.

(8) Access to the documents described in subsections (5) (b) and (6) (b) does not extend to

(a) information contained in those documents that would reveal personal information, as defined in the Personal Information Protection Act, about a person without that person's consent, other than information about

(i) the group person insured or debtor insured in respect of whom the claim is made, or

(ii) the person who requests the information, or

(b) information prescribed by regulation.

(9) A claimant's access to documents under subsections (4) to (6) extends only to information that is relevant to

(a) a claim under the contract, or

(b) a denial of such a claim.

Particulars in policy

97   (1) This section does not apply to a contract

(a) of group insurance,

(b) of creditor's group insurance, or

(c) made by a fraternal society.

(2) An insurer must set out in the policy the following:

(a) the name or a sufficient description of the insured and of the person insured;

(b) the amount, or the method of determining the amount, of the insurance money payable and the conditions under which it becomes payable;

(c) the amount, or the method of determining the amount, of the premium and the period of grace, if any, within which it may be paid;

(d) the conditions on which the contract may be reinstated if it lapses;

(e) the term of the insurance or the method of determining the dates on which the insurance starts and terminates;

(f) the following statement:

Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in the Insurance Act.

(3) If a policy contains a provision removing or restricting the right of the insured to designate persons to whom or for whose benefit insurance money is to be payable, the front page of the policy must include the following statement in conspicuous bold type:

This policy contains a provision removing or restricting the right of the insured to designate persons to whom or for whose benefit insurance money is to be payable.

Particulars in group policy

98   In the case of a contract of group insurance or creditor's group insurance, an insurer must set out in the policy the following:

(a) the name or a sufficient description of the insured;

(b) the method of determining the persons whose lives or well being or both are insured;

(c) the amount, or the method of determining the amount, of the insurance money payable and the conditions under which it becomes payable;

(d) the period of grace, if any, within which the premium may be paid;

(e) the term of the insurance or the method of determining the dates on which the insurance starts and terminates;

(f) in the case of a contract of group insurance, any provision removing or restricting the right of a group person insured to designate persons to whom or for whose benefit insurance money is to be payable;

(g) in the case of a contract of group insurance that replaces another contract of group insurance on some or all of the group person insureds under the replaced contract, whether a designation of a group person insured, a group person insured's personal representative or a beneficiary as a person to whom or for whose benefit insurance money is to be payable under the replaced contract applies to the replacing contract;

(h) the following statement:

Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in the Insurance Act.

Particulars in group certificate

99   (1) In the case of a contract of group insurance or creditor's group insurance, an insurer must issue, for delivery by the insured to each group person insured or debtor insured, a certificate or other document in which are set out the following:

(a) the name of the insurer and a sufficient identification of the contract;

(b) the amount, or the method of determining the amount, of insurance on the group person insured or debtor insured and on any person insured;

(c) the circumstances under which the insurance terminates, and the rights, if any, on termination of the insurance of the group person insured or debtor insured and of any person insured;

(d) in the case of a contract of group insurance that contains a provision removing or restricting the right of the group person insured to designate persons to whom or for whose benefit insurance money is to be payable,

(i) the method of determining the persons to whom or for whose benefit the insurance money is or may be payable, and

(ii) the following statement in conspicuous bold type:

This policy contains a provision removing or restricting the right of the group person insured to designate persons to whom or for whose benefit insurance money is to be payable;

(e) in the case of a contract of group insurance that replaces another contract of group insurance on some or all of the group person insureds under the replaced contract, whether a designation of a group person insured, a group person insured's personal representative or a beneficiary, as a person to whom or for whose benefit insurance money is to be payable under the replaced contract applies to the replacing contract;

(f) the rights of the group person insured, the debtor insured or a claimant under the contract to obtain copies of documents under section 96 (5) or (6);

(g) the following statement:

Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in the Insurance Act.

(2) This section does not apply to a contract

(a) of blanket insurance, or

(b) of group insurance of a nonrenewable type issued for a term not exceeding 6 months.

Exceptions and reductions must be set out in policy

100   (1) Subject to section 101 and except as otherwise provided in this section, the insurer must set out in the policy every exception or reduction affecting the amount payable under the contract, either in the provision affected by the exception or reduction, or under a heading such as "Exceptions" or "Reductions".

(2) If the exception or reduction affects only one provision in the policy, it must be set out in that provision.

(3) If the exception or reduction is contained in an endorsement, insertion or rider, the endorsement, insertion or rider must, unless it affects all amounts payable under the contract, make reference to the provisions in the policy affected by the exception or reduction.

(4) The exception or reduction mentioned in section 115 need not be set out in the policy.

(5) This section does not apply to a contract

(a) of group insurance,

(b) of creditor's group insurance, or

(c) made by a fraternal society.

Statutory conditions

101   Subject to section 102, the conditions set out in this section are deemed to be part of every contract, other than a contract of group insurance or creditor's group insurance, and must be printed on or attached to the policy forming part of the contract under the heading "Statutory Conditions", and no variation or omission of or addition to any statutory condition not authorized by section 102 is binding on the insured.

STATUTORY CONDITIONS
 The contract
 1. The application, this policy, any document attached to this policy when issued and any amendment to the contract agreed on in writing after this policy is issued constitute the entire contract and no agent has authority to change the contract or waive any of its provisions.
 Material facts
 2. No statement made by the insured or a person insured at the time of application for the contract may be used in defence of a claim under or to avoid the contract unless it is contained in the application or any other written statements or answers furnished as evidence of insurability. 
 Changes in occupation
 3. (1) If after this policy is issued the person insured engages for compensation in an occupation that is classified by the insurer as more hazardous than that stated in the contract, the liability under the contract is limited to the amount that the premium paid would have purchased for the more hazardous occupation according to the limits, classification of risks, and premium rates in use by the insurer at the time the person insured engaged in the more hazardous occupation.
  (2) If the person insured changes occupation from that stated in the contract to an occupation classified by the insurer as less hazardous and the insurer is so advised in writing, the insurer must either
   (a) reduce the premium rate, or
   (b) issue a policy for the unexpired term of the contract at the lower rate of premium applicable to the less hazardous occupation,
   according to the limits, classification of risks, and premium rates used by the insurer at the date of receipt of advice of the change in occupation, and must refund to the insured the amount by which the unearned premium on the contract exceeds the premium at the lower rate for the unexpired term.
 Termination of insurance
 4. (1) The contract may be terminated
   (a) by the insurer giving to the insured 15 days' notice of termination by registered mail or 5 days' written notice of termination personally delivered, or
   (b) by the insured at any time on request.
  (2) If the contract is terminated by the insurer,
   (a) the insurer must refund the excess of premium actually paid by the insured over the prorated premium for the expired time, but in no event may the prorated premium for the expired time be less than any minimum retained premium specified in the contract, and
   (b) the refund must accompany the notice.
  (3) If the contract is terminated by the insured, the insurer must refund as soon as practicable the excess of premium actually paid by the insured over the short rate premium calculated to the date of receipt of the notice according to the table in use by the insurer at the time of termination.
  (4) The 15 day period referred to in subparagraph (1) (a) of this condition starts to run on the day the registered letter or notification of it is delivered to the insured's postal address.
 Notice and proof of claim
 5. (1) The insured or a person insured, or a beneficiary entitled to make a claim, or the agent of any of them, must
   (a) give written notice of claim to the insurer
    (i) by delivery of the notice, or by sending it by registered mail to the head office or chief agency of the insurer in the province, or
    (ii) by delivery of the notice to an authorized agent of the insurer in the province,
   not later than 30 days after the date a claim arises under the contract on account of an accident, sickness or disability,
   (b) within 90 days after the date a claim arises under the contract on account of an accident, sickness or disability, furnish to the insurer such proof, as is reasonably possible in the circumstances, of
    (i) the happening of the accident or the start of the sickness or disability,
    (ii) the loss caused by the accident, sickness or disability,
    (iii) the right of the claimant to receive payment,
    (iv) the claimant's age, and
    (v) if relevant, the beneficiary's age, and
   (c) if so required by the insurer, furnish a satisfactory certificate as to the cause or nature of the accident, sickness or disability for which claim is made under the contract and, in the case of sickness or disability, its duration.
 Failure to give notice or proof
  (2) Failure to give notice of claim or furnish proof of claim within the time required by this condition does not invalidate the claim if
   (a) the notice or proof is given or furnished as soon as reasonably possible, and in no event later than one year after the date of the accident or the date a claim arises under the contract on account of sickness or disability, and it is shown that it was not reasonably possible to give the notice or furnish the proof in the time required by this condition, or
   (b) in the case of the death of the person insured, if a declaration of presumption of death is necessary, the notice or proof is given or furnished no later than one year after the date a court makes the declaration.
 Insurer to furnish forms for proof of claim
 6. The insurer must furnish forms for proof of claim within 15 days after receiving notice of claim, but if the claimant has not received the forms within that time the claimant may submit his or her proof of claim in the form of a written statement of the cause or nature of the accident, sickness or disability giving rise to the claim and of the extent of the loss.
 Rights of examination
 7. As a condition precedent to recovery of insurance money under the contract,
   (a) the claimant must give the insurer an opportunity to examine the person of the person insured when and as often as it reasonably requires while a claim is pending, and
   (b) in the case of death of the person insured, the insurer may require an autopsy, subject to any law of the applicable jurisdiction relating to autopsies.
 When money payable other than for loss of time
 8. All money payable under the contract, other than benefits for loss of time, must be paid by the insurer within 60 days after it has received proof of claim.
 When loss of time benefits payable
 9. The initial benefits for loss of time must be paid by the insurer within 30 days after it has received proof of claim, and payment must be made after that date in accordance with the terms of the contract but not less frequently than once in each succeeding 60 days while the insurer remains liable for the payments if the person insured, when required to do so, furnishes proof of continuing sickness or disability before payment.

Omission or variation of statutory conditions

102   (1) If a statutory condition is not applicable to the benefits provided by the contract, it may be omitted from the policy or varied so that it will be applicable.

(2) Statutory Conditions 3 and 7 may be omitted from the policy if the contract does not contain any provisions respecting the matters dealt with in them.

(3) Statutory Condition 4 must be omitted from the policy if the contract does not provide that it may be terminated by the insurer prior to the expiry of any period for which a premium has been accepted.

(4) Statutory Conditions 3, 4 and 7, and, subject to the restriction in subsection (5), Statutory Condition 5 may be varied; but if by reason of the variation the contract is less favourable to the insured, a person insured, or a beneficiary than it would be if the condition had not been varied, the condition is deemed to be included in the policy in the form in which it appears in section 101.

(5) Statutory Condition 5 (1) (a) and (b) may not be varied in policies providing benefits for loss of time.

(6) Statutory Conditions 8 and 9 may be varied by shortening the periods set out in them.

(7) The title of a statutory condition must be reproduced in the policy along with the statutory condition, but the number of a statutory condition may be omitted.

(8) In the case of a contract made by a fraternal society,

(a) the following provision must be printed on every policy in substitution for Statutory Condition 1:

 The contract
 1. This policy, the Act or instrument of incorporation of the society, its constitution, bylaws, and rules, and the amendments made from time to time to any of them, the application for the contract and the medical statement of the applicant, constitute the entire contract, and no agent has authority to change the contract or waive any of its provisions.

and

(b) Statutory Condition 4 (1) (b) and (3) must not be printed on the policy.

Notice of statutory conditions

103   In the case of a policy of accident and sickness insurance of a nonrenewable type issued for a term of 6 months or less or in relation to a ticket of travel, the statutory conditions need not be printed on or attached to the policy if the policy contains the following notice printed in conspicuous bold type:

Despite any other provision contained in the contract, the contract is subject to the statutory conditions in the Insurance Act respecting contracts of accident and sickness insurance.

Limitation of actions

104   (1) Subject to subsections (2) and (5), an action or proceeding against an insurer for the recovery of insurance money payable in the event of a person's death must be commenced not later than the earlier of

(a) 2 years after the proof of claim is furnished, and

(b) 6 years after the date of the death.

(2) Subject to subsection (5), if a declaration has been made under the Presumption of Death Act, an action or proceeding referred to in subsection (1) must be commenced not later than 2 years after the date of the declaration.

(3) Subject to subsection (5), an action or proceeding against an insurer for the recovery of insurance money not referred to in subsection (1) must be commenced not later than 2 years after the date the claimant knew or ought to have known of the first instance of the loss or occurrence giving rise to the claim for insurance money.

(4) If insurance money is not payable unless a loss or occurrence continues for a period of time specified in the contract, the date of the first instance of the loss or occurrence for the purposes of subsection (3) is deemed to be the first day after the end of that period.

(5) An action or proceeding against an insurer for the recovery of insurance money payable on a periodic basis must be commenced not later than the later of

(a) the last day of the applicable period under subsection (1), (2), (3) or (4) for commencing an action or proceeding, and

(b) if insurance money was paid, 2 years after the date the next payment would have been payable had the insurer continued to make periodic payments.

Sufficiency of proof and role of court

105   Sections 78 to 81 of Part 3 apply with the necessary changes in the case of insurance money payable under this Part in the event of a person's death and, for that purpose, a reference in those sections to section 73 must be read as a reference to Statutory Condition 5 (1) set out in section 101.

Termination for non-payment

106   (1) If a policy evidencing a contract or a certificate evidencing the renewal of a contract is delivered to the insured and the initial premium due under the contract or renewal has not been fully paid,

(a) the contract or the renewal of it evidenced by the policy or certificate is as binding on the insurer as if the premium had been paid even if the policy or certificate was delivered by an officer or an agent of the insurer who did not have authority to deliver it, and

(b) the contract may be terminated for non-payment of the premium by the insurer giving

(i) 15 days' notice of termination by registered mail, or

(ii) 5 days' written notice of termination personally delivered.

(2) If a premium referred to in subsection (1) has not been fully paid, the insurer may do one or both of the following:

(a) sue for any unpaid premium;

(b) if there is a claim under the contract, except in the case of a contract of group insurance or creditor's group insurance, deduct the amount of the unpaid premium from the amount for which the insurer is liable under the contract.

(3) If a premium, other than a premium referred to in subsection (1), is not fully paid at the time it is due, the premium may be paid within

(a) a period of grace of 30 days after the date the premium is due, or

(b) the period of grace within which the premium may be paid, if any, specified in the contract,

whichever is the longer period.

(4) If the event on which the insurance money becomes payable occurs during the period of grace and before the overdue premium is paid, the contract is deemed to be in effect as if the premium had been paid at the time it was due.

(5) Except in the case of a contract of group insurance or creditor's group insurance, the amount of the unpaid premium under subsection (4) may be deducted from the amount for which the insurer is liable under the contract.

(6) The 15 day period referred to in subsection (1) (b) (i) starts to run on the day the registered letter or notification of it is delivered to the insured's postal address.

(7) Subsection (1) does not apply to a contract made by a fraternal society.

Lack of insurable interest

107   (1) Subject to subsection (2), if at the time a contract would otherwise take effect, the insured has no insurable interest, the contract is void.

(2) A contract is not void for lack of insurable interest

(a) if it is a contract of group insurance, or

(b) if the person insured has consented in writing to the insurance.

(3) If the person insured is under the age of 16 years, consent to the insurance may be given by one of his or her parents or by a person standing in the place of a parent.

Persons insurable

108   Without restricting the meaning of "insurable interest", a person, in this section called the "primary person", has an insurable interest,

(a) in the case of a primary person who is a natural person, in his or her own life and well being and in the lives and well being of the following:

(i) the primary person's child or grandchild;

(ii) the primary person's spouse;

(iii) a person on whom the primary person is wholly or partly dependent for, or from whom the primary person is receiving, support or education;

(iv) the primary person's employee;

(v) a person in the duration of whose life or in whose well being the primary person has a pecuniary interest, and

(b) in the case of a primary person that is not a natural person, in the lives and well being of the following:

(i) the primary person's director, officer or employee;

(ii) a person in the duration of whose life or in whose well being the primary person has a pecuniary interest.

Termination of contract by court

109   (1) If

(a) a person whose life or well being or both are insured under a contract is someone other than the insured, and

(b) the person reasonably believes that their life or health might be endangered by the insurance on their life or well being or both continuing under that contract,

on the application of that person, the court may make the orders the court considers just in the circumstances.

(2) Without limiting subsection (1), the orders that the court may make under subsection (1) include

(a) an order that the insurance on that person under the contract be terminated in accordance with the terms of the contract, other than any terms respecting notice of termination, and

(b) an order that the amount of insurance under the contract be reduced.

(3) An application under subsection (1) must be made on at least 30 days' notice to the insured, the beneficiary, the insurer and any other person the court considers to have an interest in the contract.

(4) Despite subsection (3), if the court considers it just to do so, the court may dispense with the notice in the case of a person other than

(a) the insurer, or

(b) if the contract is a contract of group insurance or creditor's group insurance, the insured.

(5) An order made under subsection (1) binds any person having an interest in the contract.

Capacity of minors

110   Except in respect of his or her rights as a beneficiary, a minor who has reached the age of 16 years has the capacity of a person of the age of 19 years

(a) to make an enforceable contract, and

(b) in respect of a contract.

Duty to disclose

111   (1) An applicant for insurance and a person to be insured must each disclose to the insurer in the application, on a medical examination, if any, and in any written statements or answers furnished as evidence of insurability, every fact within the applicant's or person's knowledge that is material to the insurance and is not so disclosed by the other.

(2) Subject to sections 112 and 115 and subsection (3) of this section, a failure to disclose, or a misrepresentation of, a fact referred to in subsection (1) renders the contract voidable by the insurer.

(3) A failure to disclose or misrepresentation referred to in subsection (1) relating to evidence of insurability with respect to an application for

(a) additional coverage under a contract,

(b) an increase in insurance under a contract, or

(c) any other change to insurance after the policy is issued

renders the contract voidable by the insurer but only in relation to the addition, increase or change.

Failure to disclose

112   (1) Subject to section 115 and subsections (2) to (4) of this section, if a contract, including renewals of it, or an addition, increase or change referred to in section 111 (3), has been in effect for 2 years with respect to a person insured, a failure to disclose, or a misrepresentation of, a fact required by section 111 to be disclosed in respect of that person insured does not, in the absence of fraud, render the contract voidable.

(2) In the case of a contract of group insurance or creditor's group insurance, a failure to disclose, or a misrepresentation of, a fact required by section 111 to be disclosed in respect of a group person insured, a person insured or a debtor insured 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 section 111 (3) 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 2 years during the lifetime of that person, in which case the insurance, addition, increase or change is not, in the absence of fraud, voidable.

(3) If a claim arises from a loss incurred or a disability beginning before a contract, including renewals of it, has been in effect for 2 years with respect to the person in respect of whom the claim is made, subsection (1) does not apply to that claim.

(4) If a claim arises from a loss incurred or a disability beginning before the addition, increase or change has been in effect for 2 years with respect to the person in respect of whom the claim is made, subsection (1) does not apply to that claim.

Failure to disclose on reinstatement

113   Sections 111 and 112 apply, as far as applicable and with the necessary changes, to a failure at the time of reinstatement of a contract to disclose or a misrepresentation at that time, and the period of 2 years to which reference is made in section 112 begins to run in respect of a reinstatement from the date of reinstatement.

Pre-existing conditions

114   If 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 of it, has been in effect continuously for 2 years immediately before the date of loss incurred or commencement of disability with respect to that person, and

(b) 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 if the disease or physical condition was disclosed in the application for the contract.

Misstatement of age

115   (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 may 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.

(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 apply.

(3) If the age of a person affects the commencement or termination of the insurance, the correct age governs.

Termination and replacement of group policies

116   (1) If a contract of group insurance or a benefit provision in a contract of group insurance is terminated, the insurer continues, as though the contract or benefit provision had remained in full force and effect, to be liable to pay to or in respect of a group person insured under the contract benefits relating to

(a) loss of income because of disability,

(b) death,

(c) dismemberment, or

(d) accidental damage to natural teeth,

arising from an accident or sickness that occurred before the termination of the contract or benefit provision, if the disability, death, dismemberment or accidental damage to natural teeth is reported to the insurer within the 6 month period following the termination or a longer continuous period specified in the contract.

(2) Despite subsection (1), an insurer does not remain liable under a contract or benefit provision described in that subsection to pay a benefit for loss of income for the recurrence of a disability after both of the following occur:

(a) the termination of the contract or benefit provision;

(b) a continuous period of 6 months, or any longer period provided in the contract, during which the group person insured was not disabled.

(3) An insurer that is liable under subsection (1) to pay a benefit for loss of income as a result of the disability of a group person insured is not liable to pay the benefit for any period longer than the portion remaining, at the date the disability began, of the maximum period provided under the contract for the payment of a benefit for loss of income in respect of a disability of the group person insured.

(4) If a contract of group insurance, in this subsection called the "replacement contract", is entered into within 31 days after the termination of another contract of group insurance, in this subsection called the "other contract", and that replacement contract insures some or all of the same group person insureds as the other contract,

(a) the replacement contract is deemed to provide that any person who was insured under the other contract at the time of its termination is insured under the replacement contract from and after the termination of the other contract if

(i) the insurance on that person under the other contract terminated by reason only of the termination of the other contract, and

(ii) the person is a member of a class eligible for insurance under the replacement contract,

(b) every person who was insured under the other contract and who is insured under the replacement contract is entitled to receive credit for any deductible earned before the effective date of the replacement contract, and

(c) no person who was insured under the other contract at the time of its termination may be excluded from eligibility under the replacement contract by reason only of not being actively at work on the effective date of the replacement contract,

and, despite subsection (1), if the replacement contract provides that all benefits required to be paid under subsection (1) by the insurer of the other contract are to be paid instead under the replacement contract, the insurer of the other contract is not liable to pay those benefits.

Designation of beneficiary

117   (1) Subject to subsection (4), an insured may in a contract or by a declaration designate the insured, the insured's personal representative or a beneficiary as a person to whom or for whose benefit insurance money is to be payable.

(2) Subject to section 118, an insured may by declaration alter or revoke a designation referred to in subsection (1).

(3) A designation in favour of the "heirs", "next of kin" or "estate" of an insured, or the use of words having a similar meaning in a designation, is deemed to be a designation of the personal representative of the insured.

(4) Subject to the regulations, an insurer may restrict or exclude in a contract the right of an insured to designate persons to whom or for whose benefit insurance money is to be payable.

(5) A contract of group insurance replacing another contract of group insurance on some or all of the group person insureds under the replaced contract may provide that a designation applicable to the replaced contract of a group person insured, a group person insured's personal representative or a beneficiary as a person to whom or for whose benefit insurance money is to be payable is deemed to apply to the replacing contract.

(6) If a contract of group insurance replacing another contract of group insurance provides that a designation referred to in subsection (5) is deemed to apply to the replacing contract,

(a) each certificate in respect of the replacing contract must indicate that the designation under the replaced contract has been carried forward and that the group person insured should review the existing designation to ensure it reflects the group person insured's current intentions, and

(b) as between the insurer under the replacing contract and a claimant under that contract, that insurer is liable to the claimant for any errors or omissions by the previous insurer in respect of the recording of the designation carried forward under the replacing contract.

(7) If a beneficiary becomes entitled to insurance money and all or part of the insurance money remains with the insurer under a settlement option provided for in the contract or permitted by the insurer, that portion of the insurance money remaining with the insurer is deemed to be insurance money held under a contract of life insurance on the life of the beneficiary, and, subject to the provisions of the settlement option, the beneficiary has the same rights and interests with respect to the insurance money that an insured has under a contract of life insurance.

Irrevocable designation of beneficiary

118   (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 both 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.

(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.

Designation in will

119   (1) A designation in an instrument purporting to be a will is not ineffective by reason only of the fact that the instrument is invalid as a will or the designation is invalid as a bequest under the will.

(2) Despite the Wills, Estates and Succession Act, a designation in a will is of no effect against a designation made later than the making of the will.

(3) If a designation is contained in a will and subsequently the will is revoked by operation of law or otherwise, the designation is revoked.

(4) If a designation is contained in an instrument that purports to be a will and the instrument, if it were valid as a will, would be revoked by operation of law or otherwise, the designation is revoked.

Trustee for beneficiary

120   (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.

(2) A payment made by an insurer to the trustee for a beneficiary discharges the insurer to the extent of the amount of the payment.

Predeceased or disclaiming beneficiary

121   (1) If 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 for in the contract or by declaration, the share is payable

(a) to the surviving beneficiary,

(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.

(2) If 2 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.

(3) 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.

(4) A notice of disclaimer filed under subsection (3) is irrevocable.

(5) Subsection (1) 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 both are insured.

Enforcement of payment by beneficiary or trustee

122   A beneficiary may enforce in the beneficiary's own name and for the beneficiary's own benefit, and a trustee appointed under section 120 may enforce as trustee, the payment of insurance money made payable to the beneficiary or trustee in the contract or by a declaration and in accordance with the provisions of it, but the insurer may set up any defence that it could have set up against the insured or the insured's personal representative.

Documents affecting right to insurance money
and effect of assignment

123   (1) Until an insurer receives at its head or principal office in Canada an instrument or an order of a court 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 is as fully discharged to the extent of the amount paid as if there were no such instrument or order.

(2) Subsection (1) does not affect the rights or interests of any person other than the insurer.

(3) If an assignee of a contract gives notice in writing of the assignment to the insurer at its head or principal office in Canada, he or she 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 for in section 118 before the assignee gave notice to the insurer of the assignment in the manner provided for in this subsection.

(4) If 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.

(5) If 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 is deemed to be the insured.

(6) Unless the document by which a contract is assigned specifies otherwise, an assignment described in subsection (5) 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 127 made before or after that date.

(7) A contract may provide that the rights or interests of the insured or, in the case of a contract of group insurance or creditor's group insurance, of the group person insured or debtor insured, as applicable, are not assignable.

Insurance money exempt from seizure

124   (1) If a beneficiary is designated, any insurance money payable to him or her is not, from the time of the happening of the event on which it becomes payable, part of the estate of the insured, and is not subject to the claims of the creditors of the insured.

(2) While there is in effect a designation 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.

Assignment of insurance

125   (1) If a beneficiary

(a) is not designated irrevocably, or

(b) is designated irrevocably but has attained the age of 19 years and consents,

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.

(2) Despite section 118 (1), if a beneficiary is designated irrevocably and has not consented as described in subsection (l) (b) of this section, the insured may exercise any rights in respect of the contract that are prescribed by regulation.

(3) Subject to the terms of a consent under subsection (l) (b) or a court order 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.

(4) When a beneficiary who is designated irrevocably is unable to provide consent under subsection (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.

(5) The court may grant an order under subsection (4) on any notice and terms it considers just.

Entitlement to dividends

126   (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.

(2) Unless the insured directs otherwise, the insurer may apply the dividends or bonuses declared on the contract for the purpose of keeping the contract in force.

Transfer of insured's rights

127   (1) Despite the Wills, Estates and Succession 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 is deemed to be the insured.

(2) If the contract or declaration provides that 2 or more persons named in the contract or in the declaration, on the death of the insured, have successively on the death of each of them the rights and interests of the insured in the contract, this section applies successively, so far as applicable and with the necessary changes, to each of those persons and their rights and interests in the contract.

(3) Despite a nomination made under this section, the insured may, before his or her death,

(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.

Group person insured may enforce rights

128   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 under the contract as a person dependent on or related to him or her, subject to any defence available to the insurer against the group person insured, such person insured or the insured.

Debtor insured may enforce rights

129   (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 debtor insured.

(2) Subject to subsection (3), if an insurer pays insurance money in respect of a claim under subsection (1), the insurer must pay the insurance money to the creditor.

(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.

Simultaneous deaths

130   Unless a contract or a declaration otherwise provides, if 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 is payable as if the beneficiary had predeceased the person insured or group person insured.

Payment into court

131   (1) If an insurer admits liability for insurance money or any part of it and it appears to the insurer that

(a) there are adverse claimants,

(b) there is no person capable of giving and authorized to give a valid discharge who is willing to do so,

(c) the insurance money has become unclaimed property under the Unclaimed Property Act,

(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, without notice to any person, apply to the court for an order for payment of the money into court.

(2) On application under this section, the court may, on notice, if any, as it thinks necessary, make an order for payment of the insurance money into court.

(3) On payment into court of insurance money referred to in subsection (1) (c), Part 3 of the Unclaimed Property Act ceases to apply to that money.

(4) The court may fix without taxation the costs incurred for an application or order made under this section, and may order the costs to be paid out of the insurance money or by the insurer, or otherwise as it deems just.

(5) A payment made under an order under this section discharges the insurer to the extent of the payment.

Payment of insurance money for minors

132   (1) If an insurer admits liability for insurance money payable to a minor or for insurance money payable to a trustee for a beneficiary who is a minor, the insurer, within 60 days after the contract conditions respecting payment are substantially fulfilled, or within a shorter period required under the contract, must

(a) in the case of money payable to a minor, other than a minor referred to in paragraph (b), pay the money in trust for the minor

(i) to a trustee for the minor appointed in relation to that money by the insured or group person insured in a contract or by a declaration, or

(ii) if no trustee is appointed for the minor in relation to that money, to the Public Guardian and Trustee,

(b) in the case of money payable to a minor referred to in subsection (4), pay the money to the minor, and

(c) in the case of money payable to a trustee for a beneficiary who is a minor, pay the money to the trustee.

(2) An insurer who makes a payment under subsection (1) (a) (i) or (c) must, within 30 days after the date of payment, give written notice to the Public Guardian and Trustee stating the name and address of the minor, the name and address of the trustee and the amount of the payment.

(3) Payment of the insurance money referred to in subsection (1) discharges the insurer if the payment is made in accordance with subsection (1).

(4) A beneficiary who has reached the age of 18 years has the capacity of a person who has reached the age of 19 years for the purposes of receiving insurance money payable to the minor and giving a discharge for it.

Payment to representative of beneficiary

133   Despite section 132, if it appears to an insurer that a representative of a beneficiary who is a minor or otherwise under a legal disability 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.

Payments not exceeding $10 000

134   Even though insurance money is payable to a person, the insurer may, if the contract provides, but subject always to the rights of an assignee, pay an amount not exceeding $10 000 to

(a) a relative of a person insured or the group person insured, or

(b) a person appearing to the insurer to be equitably entitled to the insurance money 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 to such an expense,

and any payment discharges the insurer to the extent of the amount paid.

Payment of insurance money

135   (1) Subject to subsections (2), (4) and (5), insurance money is payable in British Columbia.

(2) In the case of a contract of group insurance, insurance money is payable in the province or territory of Canada in which the group person insured was resident at the time the person became insured.

(3) Unless a contract otherwise provides, a reference to dollars means Canadian dollars whether the contract by its terms provides for payment in Canada or elsewhere.

(4) If a person entitled to receive insurance money is not resident in British Columbia, the insurer may pay the insurance money to that person or to any other person who is entitled to receive it on the person's behalf by the law of the jurisdiction in which the payee resides, and the payment discharges the insurer to the extent of the amount paid.

(5) If insurance money is payable under a contract to a deceased person who was not resident in British Columbia at the date of their death or to that person's personal representative, the insurer may pay the insurance money to the deceased person's personal representative as appointed under the law of the jurisdiction in which the person was resident at the date of their death, and the payment discharges the insurer to the extent of the amount paid.

Action in British Columbia

136   Regardless of the place where a contract was made, a claimant who is a resident of British Columbia may bring an action in British Columbia if the insurer was authorized to transact insurance in British Columbia at the time the contract was made or is so authorized at the time the action is brought.

Insurer giving information

137   An insurer does not incur any liability for any default, error or omission in giving or withholding information as to any notice or instrument that it has received and that affects the insurance money.

Undue prominence

138   The insurer must not in the policy give undue prominence to any provision or statutory condition as compared to other provisions or statutory conditions, unless the effect of that provision or statutory condition is to increase the premium or decrease the benefits otherwise provided for in the policy.

Presumption against agency

139   An officer, agent or employee of an insurer, or a person soliciting insurance whether or not an agent of the insurer, must not be considered to be the agent of the insured, person insured, group person insured or debtor insured, to that person's prejudice, in respect of any question arising out of a contract.

Contents | Part 1 | Part 2 | Part 3 | Part 4 | Part 5-5.1 | Part 6