How a client’s address change came back to bite his auto insurer

If an auto insurer wants to prove an insured “intentionally” failed to inform it of a move, the insurer should be prepared to provide detailed logs, transcripts or recordings of the conversations the claimant had with the broker, Ontario’s Licence Appeal Tribunal has ruled.

“I do not find that [Intact’s] cursory summary of telephone calls [between the insured and his broker], four years after the calls were placed, is sufficient evidence of the details of the 2019 telephone calls,” LAT adjudicator Ulana Pahuta wrote in a decision released Jan. 3, 2024.

“I…agree with the [insured] that [Intact] could have submitted call logs or recordings of the calls [between the insured and his broker, BrokerLink], in support of its claim that the [insured] had not mentioned an address change to his broker in 2019.”

Taeme Tegbaru was involved in an automobile accident on May 6, 2019, and sought accident benefits from his auto insurer, Intact Insurance.

The motor vehicle accident report dated June 3, 2019, as well as various tax documents, indicate Tegbaru’s address at the time of his accident was in Toronto. However, the address listed on his insurance policy was in Kitchener, Ont.

Intact denied Tegbaru’s claim for accident benefits based on material misrepresentation. Tegbaru disputed the decision at the LAT.

Related: How to lie to your auto insurer and not repay your benefits

Before the tribunal, Intact contended Tegbaru “intentionally failed to disclose his move from Kitchener to Toronto,” the LAT ruling states. “It argues that by failing to notify the insurer of this change in address, the applicant paid reduced annual insurance premiums of approximately 20%….

“[Intact] submits [Tegbaru’s] move from Kitchener to Toronto represents a change in material risk to the contract of insurance, and that his intentional failure to notify the respondent of his address change precludes the [insured] from pursuing his claim for income replacement benefits.”

Tegbaru said the property ownership documents Intact submitted as evidence didn’t tell the full story. He said he continued to live in Kitchener while his Toronto home was undergoing renovations. He added that he didn’t hide his Toronto address change: his Toronto residence was referenced in his application forms for accident benefits.

Besides, Tegbaru added, he had informed his broker about the address change. He assumed his broker would tell Intact about the change.

Intact denied this, but the LAT adjudicator wasn’t persuaded by the records Intact provided of the conversations between Tegbaru and his broker.

Intact “relies on an email summary dated Aug. 4, 2023, from Intact, which provides a very brief description of the calls between [Tegbaru] and BrokerLink in 2019,” the adjudicator found. “This email summary lists four telephone calls in 2019 and has two sentence summaries for each call, which include that there was ‘no mention of address or address change.’ However, no additional information was provided.”

For this claim of intentional material misrepresentation to succeed, the LAT adjudicator’s ruling suggests, clear, detailed call logs and/or recordings with the broker are expected as evidence.

 

Feature image courtesy of iStock.com/Oleksandr Hruts